- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,960.00 / $23,275.00 / $37,782.60
| Facility | | $15,960.00 | $23,275.00 | $37,782.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,788.57 / $55,143.75 / $70,697.11
| Facility | | $38,788.57 | $55,143.75 | $70,697.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,740.79 / $36,716.30 / $45,828.90
| Facility | | $18,740.79 | $36,716.30 | $45,828.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,651.59 / $25,030.60 / $40,025.00
| Facility | | $16,651.59 | $25,030.60 | $40,025.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,317.71 / $33,300.54 / $50,593.20
| Facility | | $20,317.71 | $33,300.54 | $50,593.20 |