- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,231.70 / $28,972.70 / $48,917.50
| Facility | | $13,231.70 | $28,972.70 | $48,917.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,028.90 / $45,822.76 / $64,183.00
| Facility | | $30,028.90 | $45,822.76 | $64,183.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,882.66 / $41,301.08 / $60,627.67
| Facility | | $28,882.66 | $41,301.08 | $60,627.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,253.52 / $40,839.16 / $85,641.01
| Facility | | $21,253.52 | $40,839.16 | $85,641.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,882.66 / $44,966.98 / $60,961.91
| Facility | | $28,882.66 | $44,966.98 | $60,961.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,367.70 / $37,054.40 / $62,185.00
| Facility | | $8,367.70 | $37,054.40 | $62,185.00 |