- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $27,684.10 / $60,990.10
| Facility | | $3,182.00 | $27,684.10 | $60,990.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $30,952.64 / $53,954.25
| Facility | | $1,474.01 | $30,952.64 | $53,954.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,534.73 / $37,513.69 / $56,105.19
| Facility | | $25,534.73 | $37,513.69 | $56,105.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,967.70 / $40,527.76 / $88,940.00
| Facility | | $23,967.70 | $40,527.76 | $88,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,503.18 / $40,527.76 / $71,855.84
| Facility | | $22,503.18 | $40,527.76 | $71,855.84 |