- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,191.00 / $27,083.50 / $62,157.50
| Facility | | $19,191.00 | $27,083.50 | $62,157.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $29,470.32 / $40,610.97
| Facility | | $11,258.00 | $29,470.32 | $40,610.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,138.80 / $28,960.48 / $47,934.15
| Facility | | $19,138.80 | $28,960.48 | $47,934.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,425.69 / $24,572.87 / $48,343.31
| Facility | | $12,425.69 | $24,572.87 | $48,343.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,030.00 / $31,483.33 / $44,629.68
| Facility | | $21,030.00 | $31,483.33 | $44,629.68 |