- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $37,153.52 / $42,657.95
| Facility | | $26,915.35 | $37,153.52 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $26,302.68 / $32,359.37
| Facility | | $21,379.62 | $26,302.68 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $35,481.34 / $46,773.51
| Facility | | $19,498.45 | $35,481.34 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $67,608.30
| Facility | | $17,782.79 | $26,915.35 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $39,810.72
| Facility | | $16,595.87 | $26,915.35 | $39,810.72 |