- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,405.50 / $34,247.50 / $53,389.00
| Facility | | $24,405.50 | $34,247.50 | $53,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,550.36 / $29,506.52 / $44,222.50
| Facility | | $18,550.36 | $29,506.52 | $44,222.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,173.60 / $29,260.00 / $52,801.00
| Facility | | $21,173.60 | $29,260.00 | $52,801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.60 / $303.43 / $496.81
| Facility | | $159.60 | $303.43 | $496.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,450.56 / $32,454.66 / $53,412.80
| Facility | | $23,450.56 | $32,454.66 | $53,412.80 |