- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,093.10 / $35,608.60 / $62,660.80
| Facility | | $21,093.10 | $35,608.60 | $62,660.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,367.75 / $30,699.50 / $36,680.37
| Facility | | $27,367.75 | $30,699.50 | $36,680.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,773.50 / $28,603.56 / $47,256.16
| Facility | | $19,773.50 | $28,603.56 | $47,256.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,187.45 / $32,278.25 / $44,288.63
| Facility | | $19,187.45 | $32,278.25 | $44,288.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,700.50 / $66,700.50 / $78,278.70
| Facility | | $66,700.50 | $66,700.50 | $78,278.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $31,032.58 / $44,326.49
| Facility | | $1,787.00 | $31,032.58 | $44,326.49 |