- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,580.80 / $36,306.00 / $61,299.10
| Facility | | $16,580.80 | $36,306.00 | $61,299.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,977.75 / $54,616.41 / $70,204.99
| Facility | | $36,977.75 | $54,616.41 | $70,204.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,193.21 / $51,754.88 / $75,973.25
| Facility | | $36,193.21 | $51,754.88 | $75,973.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,633.05 / $51,176.04 / $107,317.78
| Facility | | $26,633.05 | $51,176.04 | $107,317.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,193.21 / $56,348.66 / $76,392.11
| Facility | | $36,193.21 | $56,348.66 | $76,392.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,114.00 / $46,433.32 / $71,643.13
| Facility | | $9,114.00 | $46,433.32 | $71,643.13 |