- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,625.50 / $27,321.40 / $47,802.10
| Facility | | $20,625.50 | $27,321.40 | $47,802.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $20,289.14 / $44,656.06
| Facility | | $5,939.30 | $20,289.14 | $44,656.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,930.00 / $26,212.60 / $42,678.90
| Facility | | $15,930.00 | $26,212.60 | $42,678.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,978.50 / $15,951.30 / $29,592.09
| Facility | | $6,978.50 | $15,951.30 | $29,592.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $28,156.00 / $48,364.25
| Facility | | $3,496.00 | $28,156.00 | $48,364.25 |