- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,106.20 / $30,906.60 / $50,236.20
| Facility | | $18,106.20 | $30,906.60 | $50,236.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,762.00 / $15,762.00 / $26,622.32
| Facility | | $15,762.00 | $15,762.00 | $26,622.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,525.96 / $24,556.82 / $38,740.76
| Facility | | $15,525.96 | $24,556.82 | $38,740.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,353.46 / $16,504.68 / $39,071.44
| Facility | | $7,353.46 | $16,504.68 | $39,071.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,047.00 / $25,648.24 / $35,279.67
| Facility | | $7,047.00 | $25,648.24 | $35,279.67 |