- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,608.60 / $40,225.80 / $61,894.00
| Facility | | $29,608.60 | $40,225.80 | $61,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,421.64 / $35,709.98 / $53,503.66
| Facility | | $22,421.64 | $35,709.98 | $53,503.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,877.71 / $34,400.89 / $64,057.94
| Facility | | $24,877.71 | $34,400.89 | $64,057.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.63 / $368.12 / $602.73
| Facility | | $193.63 | $368.12 | $602.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,450.11 / $39,373.85 / $64,800.17
| Facility | | $28,450.11 | $39,373.85 | $64,800.17 |