- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,889.30 / $43,192.10 / $50,513.30
| Facility | | $27,889.30 | $43,192.10 | $50,513.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,958.83 / $40,810.72 / $57,562.64
| Facility | | $26,958.83 | $40,810.72 | $57,562.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,753.79 / $35,474.69 / $55,596.78
| Facility | | $25,753.79 | $35,474.69 | $55,596.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $35,712.00 / $51,642.00
| Facility | | $20,832.00 | $35,712.00 | $51,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $40,281.56 / $66,406.64
| Facility | | $5,274.00 | $40,281.56 | $66,406.64 |