- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,872.40 / $23,806.80 / $40,195.40
| Facility | | $10,872.40 | $23,806.80 | $40,195.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,203.38 / $38,884.00 / $50,420.58
| Facility | | $26,203.38 | $38,884.00 | $50,420.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,732.80 / $33,936.98 / $49,817.58
| Facility | | $23,732.80 | $33,936.98 | $49,817.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,463.96 / $33,557.42 / $70,370.97
| Facility | | $17,463.96 | $33,557.42 | $70,370.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,732.80 / $36,949.23 / $50,092.22
| Facility | | $23,732.80 | $36,949.23 | $50,092.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,875.72 / $31,249.57 / $46,978.20
| Facility | | $6,875.72 | $31,249.57 | $46,978.20 |