- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,663.00 / $47,219.60 / $76,751.70
| Facility | | $27,663.00 | $47,219.60 | $76,751.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,543.20 / $39,477.06 / $49,787.30
| Facility | | $27,543.20 | $39,477.06 | $49,787.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,720.83 / $37,518.33 / $59,188.80
| Facility | | $23,720.83 | $37,518.33 | $59,188.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,460.36 / $37,867.39 / $70,965.39
| Facility | | $19,460.36 | $37,867.39 | $70,965.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,490.79 / $42,695.23 / $56,837.11
| Facility | | $27,490.79 | $42,695.23 | $56,837.11 |