- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,874.08 / $29,470.20 / $48,877.30
| Facility | | $22,874.08 | $29,470.20 | $48,877.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,349.42 / $26,763.39 / $39,525.08
| Facility | | $9,349.42 | $26,763.39 | $39,525.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,505.73 / $26,798.49 / $44,425.05
| Facility | | $17,505.73 | $26,798.49 | $44,425.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,376.30 / $31,854.00 / $46,986.00
| Facility | | $25,376.30 | $31,854.00 | $46,986.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,775.00 / $31,136.06 / $50,535.53
| Facility | | $15,775.00 | $31,136.06 | $50,535.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,775.00 / $27,663.32 / $41,762.10
| Facility | | $15,775.00 | $27,663.32 | $41,762.10 |