- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,906.00 / $27,571.30 / $44,756.80
| Facility | | $18,906.00 | $27,571.30 | $44,756.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,596.54 / $63,400.65 / $81,282.88
| Facility | | $44,596.54 | $63,400.65 | $81,282.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,200.09 / $42,559.57 / $51,421.17
| Facility | | $22,200.09 | $42,559.57 | $51,421.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,725.30 / $29,650.90 / $47,413.10
| Facility | | $19,725.30 | $29,650.90 | $47,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,068.47 / $39,447.37 / $59,932.02
| Facility | | $23,068.47 | $39,447.37 | $59,932.02 |