- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,028.60 / $29,179.90 / $51,053.80
| Facility | | $22,028.60 | $29,179.90 | $51,053.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,662.08 / $38,662.08 / $38,662.08
| Facility | | $38,662.08 | $38,662.08 | $38,662.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $25,380.33 / $49,185.00
| Facility | | $5,939.30 | $25,380.33 | $49,185.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,612.13 / $27,995.68 / $45,582.08
| Facility | | $16,612.13 | $27,995.68 | $45,582.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $30,071.28 / $45,930.16
| Facility | | $3,496.00 | $30,071.28 | $45,930.16 |