- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,247.50 / $25,344.80 / $41,951.50
| Facility | | $10,247.50 | $25,344.80 | $41,951.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,448.44 / $42,215.52 / $54,740.54
| Facility | | $28,448.44 | $42,215.52 | $54,740.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $33,666.61 / $53,829.36
| Facility | | $17,646.00 | $33,666.61 | $53,829.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,874.98 / $36,268.73 / $76,056.67
| Facility | | $18,874.98 | $36,268.73 | $76,056.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $36,029.22 / $53,842.65
| Facility | | $17,648.00 | $36,029.22 | $53,842.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $24,107.28 / $46,308.02
| Facility | | $5,281.00 | $24,107.28 | $46,308.02 |