- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,885.50 / $51,079.50 / $72,323.10
| Facility | | $27,885.50 | $51,079.50 | $72,323.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,104.24 / $44,879.46 / $69,786.75
| Facility | | $28,104.24 | $44,879.46 | $69,786.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,992.48 / $45,948.69 / $81,750.00
| Facility | | $28,992.48 | $45,948.69 | $81,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $42,436.13 / $96,669.54
| Facility | | $7,117.00 | $42,436.13 | $96,669.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $42,408.09 / $85,905.60
| Facility | | $3,308.00 | $42,408.09 | $85,905.60 |