- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,633.30 / $27,662.50 / $46,705.40
| Facility | | $12,633.30 | $27,662.50 | $46,705.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,250.00 / $44,547.59 / $57,764.51
| Facility | | $30,250.00 | $44,547.59 | $57,764.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,576.52 / $39,433.36 / $57,885.95
| Facility | | $27,576.52 | $39,433.36 | $57,885.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,292.39 / $38,992.32 / $81,768.14
| Facility | | $20,292.39 | $38,992.32 | $81,768.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,576.52 / $42,933.47 / $58,205.08
| Facility | | $27,576.52 | $42,933.47 | $58,205.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,989.31 / $35,895.00 / $54,586.71
| Facility | | $7,989.31 | $35,895.00 | $54,586.71 |