- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,148.10 / $30,662.90 / $53,648.40
| Facility | | $23,148.10 | $30,662.90 | $53,648.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,402.92 / $11,402.92 / $11,402.92
| Facility | | $11,402.92 | $11,402.92 | $11,402.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,244.18 / $55,899.59
| Facility | | $5,939.30 | $26,244.18 | $55,899.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,307.00 / $29,418.50 / $47,898.68
| Facility | | $17,307.00 | $29,418.50 | $47,898.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,366.53 / $48,264.45
| Facility | | $3,496.00 | $26,366.53 | $48,264.45 |