- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,370.70 / $29,633.00 / $51,846.60
| Facility | | $22,370.70 | $29,633.00 | $51,846.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,543.00 / $23,956.04 / $32,181.60
| Facility | | $13,543.00 | $23,956.04 | $32,181.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,887.87 / $52,509.67
| Facility | | $5,939.30 | $26,887.87 | $52,509.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,870.11 / $28,430.43 / $46,289.93
| Facility | | $16,870.11 | $28,430.43 | $46,289.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $30,538.26 / $52,456.30
| Facility | | $3,496.00 | $30,538.26 | $52,456.30 |