- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,363.20 / $48,291.10 / $68,375.00
| Facility | | $26,363.20 | $48,291.10 | $68,375.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,963.21 / $43,940.56 / $69,112.75
| Facility | | $27,963.21 | $43,940.56 | $69,112.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,409.80 / $43,440.38 / $77,287.33
| Facility | | $27,409.80 | $43,440.38 | $77,287.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $40,093.06 / $91,392.41
| Facility | | $7,117.00 | $40,093.06 | $91,392.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $40,093.06 / $81,216.07
| Facility | | $3,308.00 | $40,093.06 | $81,216.07 |