- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,116.40 / $30,794.70 / $49,989.60
| Facility | | $21,116.40 | $30,794.70 | $49,989.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,473.74 / $67,491.00 / $86,526.94
| Facility | | $47,473.74 | $67,491.00 | $86,526.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,795.62 / $46,185.09 / $57,433.09
| Facility | | $24,795.62 | $46,185.09 | $57,433.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,031.40 / $33,117.60 / $52,956.40
| Facility | | $22,031.40 | $33,117.60 | $52,956.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,765.53 / $44,059.37 / $66,938.99
| Facility | | $25,765.53 | $44,059.37 | $66,938.99 |