- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,742.00 / $40,140.30 / $60,774.90
| Facility | | $21,742.00 | $40,140.30 | $60,774.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,582.17 / $40,036.78 / $56,987.11
| Facility | | $23,582.17 | $40,036.78 | $56,987.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,960.07 / $39,981.11 / $72,364.00
| Facility | | $28,960.07 | $39,981.11 | $72,364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $217.09 / $424.02 / $675.77
| Facility | | $217.09 | $424.02 | $675.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,266.24 / $44,044.35 / $69,983.22
| Facility | | $30,266.24 | $44,044.35 | $69,983.22 |