- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,591.80 / $28,435.30 / $28,435.30
| Facility | | $25,591.80 | $28,435.30 | $28,435.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,144.86 / $22,144.86 / $22,703.20
| Facility | | $22,144.86 | $22,144.86 | $22,703.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,213.63 / $23,984.21 / $46,822.34
| Facility | | $15,213.63 | $23,984.21 | $46,822.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,505.21 / $32,083.00 / $49,203.02
| Facility | | $23,505.21 | $32,083.00 | $49,203.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $42,481.66 / $54,850.93
| Facility | | $6,965.00 | $42,481.66 | $54,850.93 |