- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,801.20 / $44,458.60 / $59,660.00
| Facility | | $26,801.20 | $44,458.60 | $59,660.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,246.51 / $26,246.51 / $36,513.12
| Facility | | $26,246.51 | $26,246.51 | $36,513.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,982.62 / $37,106.67 / $59,372.09
| Facility | | $21,982.62 | $37,106.67 | $59,372.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,007.38 / $35,796.00 / $82,094.55
| Facility | | $22,007.38 | $35,796.00 | $82,094.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,020.30 / $35,261.44 / $49,952.12
| Facility | | $26,020.30 | $35,261.44 | $49,952.12 |