- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,576.40 / $28,581.00 / $50,005.90
| Facility | | $21,576.40 | $28,581.00 | $50,005.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,538.76 / $33,538.76 / $33,538.76
| Facility | | $33,538.76 | $33,538.76 | $33,538.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,235.92 / $53,635.11
| Facility | | $5,939.30 | $26,235.92 | $53,635.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,271.18 / $27,421.08 / $44,646.53
| Facility | | $16,271.18 | $27,421.08 | $44,646.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,454.08 / $51,298.00
| Facility | | $3,496.00 | $29,454.08 | $51,298.00 |