- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,906.70 / $44,767.70 / $52,355.90
| Facility | | $28,906.70 | $44,767.70 | $52,355.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,032.89 / $45,464.29 / $64,126.40
| Facility | | $30,032.89 | $45,464.29 | $64,126.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,693.24 / $37,590.07 / $57,624.85
| Facility | | $26,693.24 | $37,590.07 | $57,624.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,603.00 / $41,002.00 / $53,988.00
| Facility | | $23,603.00 | $41,002.00 | $53,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $41,750.96 / $68,829.03
| Facility | | $5,274.00 | $41,750.96 | $68,829.03 |