- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,219.60 / $36,056.19 / $63,084.70
| Facility | | $27,219.60 | $36,056.19 | $63,084.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,800.00 / $26,892.25 / $40,682.83
| Facility | | $14,800.00 | $26,892.25 | $40,682.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $29,103.43 / $58,645.22
| Facility | | $5,939.30 | $29,103.43 | $58,645.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,575.57 / $34,592.92 / $56,323.58
| Facility | | $19,575.57 | $34,592.92 | $56,323.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $37,157.62 / $63,826.56
| Facility | | $3,496.00 | $37,157.62 | $63,826.56 |