- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,988.80 / $27,692.00 / $44,952.80
| Facility | | $18,988.80 | $27,692.00 | $44,952.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,825.66 / $76,521.21 / $98,104.11
| Facility | | $53,825.66 | $76,521.21 | $98,104.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,297.31 / $43,480.55 / $54,260.50
| Facility | | $22,297.31 | $43,480.55 | $54,260.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,811.59 / $29,780.80 / $47,620.70
| Facility | | $19,811.59 | $29,780.80 | $47,620.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,169.50 / $39,620.12 / $60,194.50
| Facility | | $23,169.50 | $39,620.12 | $60,194.50 |