- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,312.00 / $32,582.20 / $42,824.20
| Facility | | $22,312.00 | $32,582.20 | $42,824.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,463.19 / $27,964.29 / $30,027.96
| Facility | | $25,463.19 | $27,964.29 | $30,027.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,372.57 / $28,248.42 / $47,778.40
| Facility | | $10,372.57 | $28,248.42 | $47,778.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $31,170.50 / $54,777.63
| Facility | | $14,646.00 | $31,170.50 | $54,777.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,065.52 / $36,523.78 / $53,327.70
| Facility | | $28,065.52 | $36,523.78 | $53,327.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,065.52 / $33,953.72 / $53,327.70
| Facility | | $28,065.52 | $33,953.72 | $53,327.70 |