- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,959.90 / $24,328.80 / $40,391.50
| Facility | | $18,959.90 | $24,328.80 | $40,391.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,855.18 / $22,272.95 / $37,698.62
| Facility | | $14,855.18 | $22,272.95 | $37,698.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,970.63 / $25,949.44 / $37,398.00
| Facility | | $20,970.63 | $25,949.44 | $37,398.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,537.74 / $26,051.64 / $66,426.49
| Facility | | $12,537.74 | $26,051.64 | $66,426.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,537.74 / $24,873.17 / $34,958.01
| Facility | | $12,537.74 | $24,873.17 | $34,958.01 |