- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,007.50 / $32,100.80 / $56,054.60
| Facility | | $23,007.50 | $32,100.80 | $56,054.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,803.76 / $21,803.76 / $21,803.76
| Facility | | $21,803.76 | $21,803.76 | $21,803.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,932.49 / $47,782.28
| Facility | | $5,939.30 | $24,932.49 | $47,782.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,756.09 / $32,539.63 / $50,046.98
| Facility | | $19,756.09 | $32,539.63 | $50,046.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $35,790.00 / $56,713.84
| Facility | | $3,496.00 | $35,790.00 | $56,713.84 |