- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,771.40 / $38,436.60 / $57,326.50
| Facility | | $28,771.40 | $38,436.60 | $57,326.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,354.61 / $30,555.48 / $46,440.80
| Facility | | $22,354.61 | $30,555.48 | $46,440.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,773.24 / $37,750.32 / $52,619.60
| Facility | | $24,773.24 | $37,750.32 | $52,619.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,689.00 / $21,689.00 / $21,689.00
| Facility | | $21,689.00 | $21,689.00 | $21,689.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,845.00 / $38,036.94 / $48,933.90
| Facility | | $10,845.00 | $38,036.94 | $48,933.90 |