- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,108.20 / $36,809.30 / $48,178.20
| Facility | | $22,108.20 | $36,809.30 | $48,178.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,650.01 / $36,650.01 / $36,650.01
| Facility | | $36,650.01 | $36,650.01 | $36,650.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,043.21 / $30,514.05 / $46,229.44
| Facility | | $19,043.21 | $30,514.05 | $46,229.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,796.25 / $32,193.39 / $49,867.66
| Facility | | $20,796.25 | $32,193.39 | $49,867.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,927.23 / $30,939.20 / $47,192.05
| Facility | | $18,927.23 | $30,939.20 | $47,192.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $38,088.08 / $54,712.28
| Facility | | $10,403.00 | $38,088.08 | $54,712.28 |