- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,348.90 / $26,111.00 / $43,350.50
| Facility | | $20,348.90 | $26,111.00 | $43,350.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,526.34 / $23,768.36 / $39,401.86
| Facility | | $15,526.34 | $23,768.36 | $39,401.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,506.88 / $27,850.42 / $40,045.51
| Facility | | $22,506.88 | $27,850.42 | $40,045.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,456.22 / $26,753.51 / $69,427.64
| Facility | | $13,456.22 | $26,753.51 | $69,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,456.22 / $26,695.31 / $37,518.94
| Facility | | $13,456.22 | $26,695.31 | $37,518.94 |