- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,199.59 / $27,257.60 / $45,254.10
| Facility | | $17,199.59 | $27,257.60 | $45,254.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,684.78 / $21,998.67 / $37,266.21
| Facility | | $14,684.78 | $21,998.67 | $37,266.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,348.00 / $29,073.37 / $41,803.96
| Facility | | $23,348.00 | $29,073.37 | $41,803.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,047.11 / $27,928.29 / $65,664.53
| Facility | | $14,047.11 | $27,928.29 | $65,664.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,047.11 / $27,867.53 / $39,166.44
| Facility | | $14,047.11 | $27,867.53 | $39,166.44 |