- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,298.70 / $29,460.40 / $33,966.10
| Facility | | $24,298.70 | $29,460.40 | $33,966.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,012.78 / $46,012.78 / $46,012.78
| Facility | | $46,012.78 | $46,012.78 | $46,012.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,702.00 / $6,578.00
| Facility | | $1,252.00 | $3,702.00 | $6,578.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,615.44 / $34,405.82 / $59,051.15
| Facility | | $21,615.44 | $34,405.82 | $59,051.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $33,481.57 / $51,992.59
| Facility | | $3,137.00 | $33,481.57 | $51,992.59 |