- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,708.00 / $31,582.20 / $55,575.50
| Facility | | $18,708.00 | $31,582.20 | $55,575.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,135.36 / $28,245.67 / $46,838.32
| Facility | | $19,135.36 | $28,245.67 | $46,838.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,017.84 / $28,628.40 / $39,280.71
| Facility | | $17,017.84 | $28,628.40 | $39,280.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59,158.60 / $59,158.60 / $69,427.64
| Facility | | $59,158.60 | $59,158.60 | $69,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $27,523.59 / $39,314.29
| Facility | | $1,787.00 | $27,523.59 | $39,314.29 |