- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,966.50 / $48,050.50 / $64,480.00
| Facility | | $28,966.50 | $48,050.50 | $64,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,237.36 / $19,237.36 / $19,237.36
| Facility | | $19,237.36 | $19,237.36 | $19,237.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,174.10 / $37,429.87 / $59,889.24
| Facility | | $22,174.10 | $37,429.87 | $59,889.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,785.38 / $38,688.00 / $88,727.06
| Facility | | $23,785.38 | $38,688.00 | $88,727.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,072.01 / $38,110.26 / $54,653.25
| Facility | | $28,072.01 | $38,110.26 | $54,653.25 |