- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,562.90 / $36,807.00 / $59,826.80
| Facility | | $21,562.90 | $36,807.00 | $59,826.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $28,197.43 / $33,762.60
| Facility | | $11,258.00 | $28,197.43 | $33,762.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,490.02 / $29,244.96 / $46,136.75
| Facility | | $18,490.02 | $29,244.96 | $46,136.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,464.86 / $24,771.68 / $46,530.57
| Facility | | $12,464.86 | $24,771.68 | $46,530.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.00 / $30,165.05 / $42,262.15
| Facility | | $6,292.00 | $30,165.05 | $42,262.15 |