- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,988.30 / $30,152.40 / $51,308.50
| Facility | | $21,988.30 | $30,152.40 | $51,308.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,052.19 / $23,052.19 / $23,052.19
| Facility | | $23,052.19 | $23,052.19 | $23,052.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,494.00 / $33,769.51 / $52,315.35
| Facility | | $3,494.00 | $33,769.51 | $52,315.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,217.58 / $34,338.50 / $57,839.77
| Facility | | $22,217.58 | $34,338.50 | $57,839.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $34,701.74 / $61,895.36
| Facility | | $4,062.00 | $34,701.74 | $61,895.36 |