- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,306.30 / $36,838.00 / $80,754.00
| Facility | | $23,306.30 | $36,838.00 | $80,754.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,868.46 / $72,134.64 / $118,460.20
| Facility | | $48,868.46 | $72,134.64 | $118,460.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,727.79 / $41,598.53 / $57,076.88
| Facility | | $24,727.79 | $41,598.53 | $57,076.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,918.12 / $90,264.30 / $105,932.82
| Facility | | $42,918.12 | $90,264.30 | $105,932.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $37,636.00 / $56,819.91
| Facility | | $2,520.00 | $37,636.00 | $56,819.91 |