- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,763.50 / $39,865.40 / $56,445.20
| Facility | | $21,763.50 | $39,865.40 | $56,445.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,831.39 / $36,617.60 / $57,157.76
| Facility | | $22,831.39 | $36,617.60 | $57,157.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,627.44 / $35,861.06 / $63,802.52
| Facility | | $22,627.44 | $35,861.06 | $63,802.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $33,944.07 / $75,446.60
| Facility | | $7,117.00 | $33,944.07 | $75,446.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $33,097.76 / $67,045.78
| Facility | | $3,308.00 | $33,097.76 | $67,045.78 |