- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,692.40 / $39,789.60 / $46,534.10
| Facility | | $25,692.40 | $39,789.60 | $46,534.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,380.35 / $39,935.01 / $56,327.47
| Facility | | $26,380.35 | $39,935.01 | $56,327.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,725.03 / $34,480.00 / $51,217.13
| Facility | | $23,725.03 | $34,480.00 | $51,217.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $34,773.00 / $47,985.00
| Facility | | $20,832.00 | $34,773.00 | $47,985.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $37,108.37 / $61,175.44
| Facility | | $5,274.00 | $37,108.37 | $61,175.44 |