- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,210.80 / $37,021.19 / $52,418.10
| Facility | | $20,210.80 | $37,021.19 | $52,418.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,961.20 / $36,825.80 / $57,482.75
| Facility | | $22,961.20 | $36,825.80 | $57,482.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,102.00 / $31,857.10 / $59,250.52
| Facility | | $16,102.00 | $31,857.10 | $59,250.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $31,925.46 / $70,063.85
| Facility | | $7,117.00 | $31,925.46 | $70,063.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $30,736.41 / $62,262.39
| Facility | | $3,308.00 | $30,736.41 | $62,262.39 |