- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,377.50 / $29,336.20 / $51,623.20
| Facility | | $17,377.50 | $29,336.20 | $51,623.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,217.28 / $33,217.28 / $33,217.28
| Facility | | $33,217.28 | $33,217.28 | $33,217.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,108.06 / $14,956.32 / $24,502.57
| Facility | | $10,108.06 | $14,956.32 | $24,502.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,777.00 / $26,592.47 / $36,487.23
| Facility | | $15,777.00 | $26,592.47 | $36,487.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,971.80 / $51,971.80 / $60,993.32
| Facility | | $51,971.80 | $51,971.80 | $60,993.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $26,959.42 / $36,322.96
| Facility | | $2,520.00 | $26,959.42 | $36,322.96 |