- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,374.00 / $23,910.90 / $31,427.20
| Facility | | $16,374.00 | $23,910.90 | $31,427.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,669.88 / $15,441.21 / $26,116.73
| Facility | | $5,669.88 | $15,441.21 | $26,116.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,234.39 / $24,127.85 / $43,037.28
| Facility | | $17,234.39 | $24,127.85 | $43,037.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,596.25 / $26,803.48 / $39,135.26
| Facility | | $20,596.25 | $26,803.48 | $39,135.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,596.25 / $24,917.41 / $39,135.26
| Facility | | $20,596.25 | $24,917.41 | $39,135.26 |