- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,338.70 / $38,715.00 / $51,952.50
| Facility | | $23,338.70 | $38,715.00 | $51,952.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,378.20 / $20,378.20 / $20,378.20
| Facility | | $20,378.20 | $20,378.20 | $20,378.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,934.30 / $31,410.68 / $50,258.30
| Facility | | $17,934.30 | $31,410.68 | $50,258.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,164.24 / $31,171.50 / $71,488.72
| Facility | | $19,164.24 | $31,171.50 | $71,488.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,618.04 / $30,718.47 / $44,267.69
| Facility | | $22,618.04 | $30,718.47 | $44,267.69 |