- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,825.30 / $30,272.50 / $51,112.00
| Facility | | $13,825.30 | $30,272.50 | $51,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,434.13 / $46,517.66 / $60,173.61
| Facility | | $26,434.13 | $46,517.66 | $60,173.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,178.38 / $43,153.91 / $63,347.51
| Facility | | $30,178.38 | $43,153.91 | $63,347.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,206.99 / $42,671.26 / $89,482.99
| Facility | | $22,206.99 | $42,671.26 | $89,482.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,178.38 / $46,984.26 / $63,696.75
| Facility | | $30,178.38 | $46,984.26 | $63,696.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,743.10 / $38,716.71 / $59,736.99
| Facility | | $8,743.10 | $38,716.71 | $59,736.99 |