- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $27,542.29 / $41,686.94
| Facility | | $21,379.62 | $27,542.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $26,302.68
| Facility | | $22,908.68 | $22,908.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $24,547.09 / $39,810.72
| Facility | | $14,125.38 | $24,547.09 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $32,359.37 / $41,686.94
| Facility | | $20,892.96 | $32,359.37 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $32,359.37 / $48,977.88
| Facility | | $17,782.79 | $32,359.37 | $48,977.88 |