- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $26,915.35 / $30,902.95
| Facility | | $20,892.96 | $26,915.35 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $23,988.33 / $28,840.32
| Facility | | $20,417.38 | $23,988.33 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $30,199.52 / $38,018.94
| Facility | | $18,620.87 | $30,199.52 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $28,183.83 / $36,307.81
| Facility | | $1,513.56 | $28,183.83 | $36,307.81 |