- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,895.70 / $30,328.60 / $53,063.50
| Facility | | $22,895.70 | $30,328.60 | $53,063.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,038.90 / $23,236.09 / $33,159.98
| Facility | | $19,038.90 | $23,236.09 | $33,159.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,054.50 / $50,672.00
| Facility | | $5,939.30 | $26,054.50 | $50,672.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,266.08 / $29,097.75 / $47,376.45
| Facility | | $17,266.08 | $29,097.75 | $47,376.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,079.06 / $53,687.57
| Facility | | $3,496.00 | $26,079.06 | $53,687.57 |