- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,478.20 / $39,635.00 / $69,746.20
| Facility | | $23,478.20 | $39,635.00 | $69,746.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,347.14 / $35,730.87 / $59,108.66
| Facility | | $24,347.14 | $35,730.87 | $59,108.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,357.06 / $35,928.10 / $49,296.54
| Facility | | $21,357.06 | $35,928.10 | $49,296.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77,215.70 / $77,215.70 / $90,619.18
| Facility | | $77,215.70 | $77,215.70 | $90,619.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $34,541.57 / $49,338.68
| Facility | | $1,787.00 | $34,541.57 | $49,338.68 |