- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,079.00 / $30,079.00 / $35,649.60
| Facility | | $30,079.00 | $30,079.00 | $35,649.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,487.79 / $34,961.78 / $52,300.70
| Facility | | $21,487.79 | $34,961.78 | $52,300.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,600.92 / $30,448.84 / $51,805.18
| Facility | | $24,600.92 | $30,448.84 | $51,805.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,010.02 / $35,315.12 / $57,805.78
| Facility | | $22,010.02 | $35,315.12 | $57,805.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.10 / $19,949.71 / $29,496.95
| Facility | | $316.10 | $19,949.71 | $29,496.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,046.32 / $34,889.85 / $41,004.32
| Facility | | $25,046.32 | $34,889.85 | $41,004.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,604.30 / $37,215.12 / $46,912.69
| Facility | | $22,604.30 | $37,215.12 | $46,912.69 |