- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,497.00 / $49,688.20 / $64,537.10
| Facility | | $28,497.00 | $49,688.20 | $64,537.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,786.66 / $52,660.63 / $74,276.67
| Facility | | $34,786.66 | $52,660.63 | $74,276.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,941.98 / $47,907.40 / $73,441.12
| Facility | | $30,941.98 | $47,907.40 | $73,441.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,818.00 / $47,345.00 / $65,018.00
| Facility | | $27,818.00 | $47,345.00 | $65,018.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $51,159.60 / $87,720.51
| Facility | | $5,274.00 | $51,159.60 | $87,720.51 |