- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,507.90 / $29,453.20 / $29,453.20
| Facility | | $26,507.90 | $29,453.20 | $29,453.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,096.53 / $25,096.53 / $25,096.53
| Facility | | $25,096.53 | $25,096.53 | $25,096.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,459.54 / $16,900.74 / $34,546.96
| Facility | | $9,459.54 | $16,900.74 | $34,546.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,805.00 / $32,428.95 / $50,964.37
| Facility | | $14,805.00 | $32,428.95 | $50,964.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,335.07 / $43,022.31 / $69,109.44
| Facility | | $14,335.07 | $43,022.31 | $69,109.44 |