- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,638.40 / $31,556.00 / $51,225.30
| Facility | | $21,638.40 | $31,556.00 | $51,225.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,198.76 / $51,461.95 / $65,976.86
| Facility | | $36,198.76 | $51,461.95 | $65,976.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,408.57 / $47,326.79 / $58,852.84
| Facility | | $25,408.57 | $47,326.79 | $58,852.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,576.10 / $33,936.19 / $54,265.50
| Facility | | $22,576.10 | $33,936.19 | $54,265.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,402.45 / $45,148.52 / $68,593.73
| Facility | | $26,402.45 | $45,148.52 | $68,593.73 |