- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,593.00 / $42,416.60 / $61,997.30
| Facility | | $31,593.00 | $42,416.60 | $61,997.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,996.58 / $38,878.65 / $51,506.13
| Facility | | $26,996.58 | $38,878.65 | $51,506.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,902.38 / $39,389.04 / $55,337.52
| Facility | | $19,902.38 | $39,389.04 | $55,337.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,686.00 / $27,686.00 / $27,686.00
| Facility | | $27,686.00 | $27,686.00 | $27,686.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,845.00 / $41,283.30 / $54,000.87
| Facility | | $10,845.00 | $41,283.30 | $54,000.87 |