- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,863.20 / $31,061.50 / $45,096.00
| Facility | | $22,863.20 | $31,061.50 | $45,096.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.75 / $27,581.45 / $41,317.36
| Facility | | $17,378.75 | $27,581.45 | $41,317.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,945.16 / $27,535.50 / $49,838.00
| Facility | | $19,945.16 | $27,535.50 | $49,838.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $284.25 / $465.41
| Facility | | $150.00 | $284.25 | $465.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,968.59 / $30,403.67 / $50,037.35
| Facility | | $21,968.59 | $30,403.67 | $50,037.35 |