- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,572.80 / $29,900.80 / $52,315.10
| Facility | | $22,572.80 | $29,900.80 | $52,315.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,330.00 / $24,464.35 / $32,711.38
| Facility | | $10,330.00 | $24,464.35 | $32,711.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $25,053.78 / $51,218.41
| Facility | | $5,939.30 | $25,053.78 | $51,218.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,022.54 / $28,687.33 / $46,708.20
| Facility | | $17,022.54 | $28,687.33 | $46,708.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $25,711.21 / $47,064.88
| Facility | | $3,496.00 | $25,711.21 | $47,064.88 |