- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,656.30 / $32,951.40 / $32,951.40
| Facility | | $29,656.30 | $32,951.40 | $32,951.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,224.13 / $29,224.13 / $29,224.13
| Facility | | $29,224.13 | $29,224.13 | $29,224.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,352.09 / $20,725.28 / $37,552.48
| Facility | | $9,352.09 | $20,725.28 | $37,552.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,942.00 / $37,147.11 / $57,017.48
| Facility | | $19,942.00 | $37,147.11 | $57,017.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,677.71 / $49,228.62 / $63,562.39
| Facility | | $26,677.71 | $49,228.62 | $63,562.39 |