- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,111.00 / $36,719.50 / $46,787.80
| Facility | | $15,111.00 | $36,719.50 | $46,787.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,488.46 / $40,098.68 / $56,558.32
| Facility | | $26,488.46 | $40,098.68 | $56,558.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,663.44 / $34,731.67 / $53,242.97
| Facility | | $24,663.44 | $34,731.67 | $53,242.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $34,880.00 / $49,551.00
| Facility | | $20,832.00 | $34,880.00 | $49,551.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $38,576.16 / $63,595.17
| Facility | | $5,274.00 | $38,576.16 | $63,595.17 |