- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,689.00 / $26,080.80 / $45,631.50
| Facility | | $19,689.00 | $26,080.80 | $45,631.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,691.80 / $26,108.22 / $35,549.87
| Facility | | $14,691.80 | $26,108.22 | $35,549.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,842.82 / $45,052.95
| Facility | | $5,939.30 | $22,842.82 | $45,052.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,847.82 / $25,022.37 / $40,740.98
| Facility | | $14,847.82 | $25,022.37 | $40,740.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,877.52 / $41,052.08
| Facility | | $3,496.00 | $26,877.52 | $41,052.08 |