- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,925.60 / $31,692.80 / $55,450.30
| Facility | | $23,925.60 | $31,692.80 | $55,450.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,042.26 / $33,042.26 / $33,042.26
| Facility | | $33,042.26 | $33,042.26 | $33,042.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $26,360.04 / $52,754.33
| Facility | | $5,939.30 | $26,360.04 | $52,754.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,983.75 / $32,188.83 / $49,507.43
| Facility | | $20,983.75 | $32,188.83 | $49,507.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $27,252.09 / $56,102.41
| Facility | | $3,496.00 | $27,252.09 | $56,102.41 |