- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,689.00 / $36,687.00 / $42,905.60
| Facility | | $23,689.00 | $36,687.00 | $42,905.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,153.58 / $35,050.28 / $49,437.66
| Facility | | $23,153.58 | $35,050.28 | $49,437.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,875.06 / $33,482.00 / $47,223.46
| Facility | | $21,875.06 | $33,482.00 | $47,223.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,832.00 / $30,264.00 / $44,101.00
| Facility | | $20,832.00 | $30,264.00 | $44,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $42,380.68 / $56,405.27
| Facility | | $5,274.00 | $42,380.68 | $56,405.27 |