- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,297.80 / $31,442.00 / $31,442.00
| Facility | | $28,297.80 | $31,442.00 | $31,442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,841.33 / $42,841.33 / $49,201.84
| Facility | | $42,841.33 | $42,841.33 | $49,201.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,405.42 / $24,786.28 / $43,280.16
| Facility | | $13,405.42 | $24,786.28 | $43,280.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,622.82 / $35,495.33 / $54,405.62
| Facility | | $19,622.82 | $35,495.33 | $54,405.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,729.00 / $39,736.31 / $60,650.73
| Facility | | $21,729.00 | $39,736.31 | $60,650.73 |