- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,879.30 / $40,355.60 / $51,421.90
| Facility | | $25,879.30 | $40,355.60 | $51,421.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,284.08 / $32,284.08 / $32,284.08
| Facility | | $32,284.08 | $32,284.08 | $32,284.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,767.00 / $24,665.78 / $48,692.16
| Facility | | $14,767.00 | $24,665.78 | $48,692.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,027.05 / $41,924.44 / $58,733.07
| Facility | | $22,027.05 | $41,924.44 | $58,733.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,839.04 / $45,733.74 / $58,733.07
| Facility | | $39,839.04 | $45,733.74 | $58,733.07 |