- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,488.80 / $31,380.00 / $41,244.19
| Facility | | $21,488.80 | $31,380.00 | $41,244.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,665.08 / $17,665.08 / $17,665.08
| Facility | | $17,665.08 | $17,665.08 | $17,665.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,514.17 / $17,740.53 / $30,005.72
| Facility | | $6,514.17 | $17,740.53 | $30,005.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,829.67 / $31,519.48 / $52,756.50
| Facility | | $21,829.67 | $31,519.48 | $52,756.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,029.98 / $35,176.16 / $51,360.06
| Facility | | $27,029.98 | $35,176.16 | $51,360.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,029.98 / $32,700.93 / $51,360.06
| Facility | | $27,029.98 | $32,700.93 | $51,360.06 |