- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,650.60 / $35,770.00 / $52,950.00
| Facility | | $24,650.60 | $35,770.00 | $52,950.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,288.56 / $32,312.72 / $48,413.60
| Facility | | $20,288.56 | $32,312.72 | $48,413.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,371.68 / $32,266.00 / $58,400.00
| Facility | | $23,371.68 | $32,266.00 | $58,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.20 / $333.08 / $545.37
| Facility | | $175.20 | $333.08 | $545.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,742.72 / $35,626.92 / $58,633.60
| Facility | | $25,742.72 | $35,626.92 | $58,633.60 |