- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,538.70 / $28,715.00 / $44,333.50
| Facility | | $19,538.70 | $28,715.00 | $44,333.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,459.98 / $50,411.67 / $64,630.34
| Facility | | $35,459.98 | $50,411.67 | $64,630.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,990.13 / $42,515.86 / $50,934.86
| Facility | | $21,990.13 | $42,515.86 | $50,934.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,538.70 / $29,370.50 / $46,964.70
| Facility | | $19,538.70 | $29,370.50 | $46,964.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,850.31 / $39,074.30 / $59,365.22
| Facility | | $22,850.31 | $39,074.30 | $59,365.22 |