- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,536.30 / $47,337.00 / $63,522.50
| Facility | | $28,536.30 | $47,337.00 | $63,522.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,212.14 / $28,212.14 / $32,266.37
| Facility | | $28,212.14 | $28,212.14 | $32,266.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,904.77 / $40,351.26 / $64,563.56
| Facility | | $23,904.77 | $40,351.26 | $64,563.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,432.18 / $38,113.50 / $87,409.50
| Facility | | $23,432.18 | $38,113.50 | $87,409.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,820.31 / $37,544.33 / $53,841.67
| Facility | | $27,820.31 | $37,544.33 | $53,841.67 |