- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,132.80 / $36,652.00 / $59,497.70
| Facility | | $25,132.80 | $36,652.00 | $59,497.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,238.93 / $46,238.93 / $46,238.93
| Facility | | $46,238.93 | $46,238.93 | $46,238.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,302.82 / $75,777.92 / $97,151.18
| Facility | | $53,302.82 | $75,777.92 | $97,151.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,511.81 / $51,346.31 / $68,357.03
| Facility | | $29,511.81 | $51,346.31 | $68,357.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,221.90 / $39,416.60 / $63,028.90
| Facility | | $26,221.90 | $39,416.60 | $63,028.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,666.20 / $52,439.59 / $79,670.98
| Facility | | $30,666.20 | $52,439.59 | $79,670.98 |