- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,535.10 / $35,723.00 / $47,937.50
| Facility | | $21,535.10 | $35,723.00 | $47,937.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,529.64 / $19,529.64 / $19,529.64
| Facility | | $19,529.64 | $19,529.64 | $19,529.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,093.54 / $26,893.55 / $43,030.71
| Facility | | $15,093.54 | $26,893.55 | $43,030.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,683.18 / $28,762.50 / $65,963.92
| Facility | | $17,683.18 | $28,762.50 | $65,963.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,870.07 / $28,332.98 / $40,631.83
| Facility | | $20,870.07 | $28,332.98 | $40,631.83 |