- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,098.90 / $34,308.00 / $55,764.90
| Facility | | $20,098.90 | $34,308.00 | $55,764.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,640.00 / $27,907.61 / $37,454.87
| Facility | | $9,640.00 | $27,907.61 | $37,454.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,234.66 / $27,259.42 / $43,004.36
| Facility | | $17,234.66 | $27,259.42 | $43,004.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,624.00 / $21,965.56 / $43,371.44
| Facility | | $10,624.00 | $21,965.56 | $43,371.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $28,470.95 / $39,162.37
| Facility | | $6,842.00 | $28,470.95 | $39,162.37 |