- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,889.90 / $26,398.50 / $46,097.30
| Facility | | $19,889.90 | $26,398.50 | $46,097.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,596.33 / $38,596.33 / $38,596.33
| Facility | | $38,596.33 | $38,596.33 | $38,596.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $21,216.12 / $43,372.94
| Facility | | $5,939.30 | $21,216.12 | $43,372.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,595.03 / $28,709.97 / $49,535.00
| Facility | | $17,595.03 | $28,709.97 | $49,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $30,008.69 / $46,639.36
| Facility | | $3,496.00 | $30,008.69 | $46,639.36 |