- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,753.00 / $36,098.10 / $58,598.60
| Facility | | $24,753.00 | $36,098.10 | $58,598.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,837.45 / $68,008.08 / $87,189.84
| Facility | | $47,837.45 | $68,008.08 | $87,189.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,065.84 / $50,570.38 / $67,324.03
| Facility | | $29,065.84 | $50,570.38 | $67,324.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,825.60 / $38,821.00 / $62,076.40
| Facility | | $25,825.60 | $38,821.00 | $62,076.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,003.89 / $51,647.13 / $78,467.00
| Facility | | $28,003.89 | $51,647.13 | $78,467.00 |