- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,507.70 / $30,463.50 / $50,166.80
| Facility | | $10,507.70 | $30,463.50 | $50,166.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,826.92 / $50,196.81 / $65,089.81
| Facility | | $33,826.92 | $50,196.81 | $65,089.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $40,259.50 / $64,370.70
| Facility | | $17,646.00 | $40,259.50 | $64,370.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,571.25 / $43,371.19 / $90,950.77
| Facility | | $22,571.25 | $43,371.19 | $90,950.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $43,084.78 / $64,386.59
| Facility | | $17,648.00 | $43,084.78 | $64,386.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,295.00 / $29,624.65 / $58,913.76
| Facility | | $8,295.00 | $29,624.65 | $58,913.76 |