- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,287.00 / $38,679.40 / $78,623.80
| Facility | | $24,287.00 | $38,679.40 | $78,623.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,223.69 / $38,109.56 / $41,491.61
| Facility | | $27,223.69 | $38,109.56 | $41,491.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,692.52 / $35,966.68 / $41,119.21
| Facility | | $28,692.52 | $35,966.68 | $41,119.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,750.50 / $39,462.68 / $54,244.96
| Facility | | $23,750.50 | $39,462.68 | $54,244.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,825.99 / $43,825.99 / $43,825.99
| Facility | | $43,825.99 | $43,825.99 | $43,825.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $36,798.61 / $54,177.94
| Facility | | $1,518.00 | $36,798.61 | $54,177.94 |