- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,286.00 / $38,032.00 / $79,117.60
| Facility | | $17,286.00 | $38,032.00 | $79,117.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,371.71 / $31,371.71 / $31,371.71
| Facility | | $31,371.71 | $31,371.71 | $31,371.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,852.43 / $42,187.00 / $62,865.92
| Facility | | $24,852.43 | $42,187.00 | $62,865.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,875.77 / $31,477.41 / $64,323.37
| Facility | | $15,875.77 | $31,477.41 | $64,323.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,920.00 / $42,815.52 / $58,422.75
| Facility | | $23,920.00 | $42,815.52 | $58,422.75 |