- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,975.30 / $26,221.60 / $44,272.60
| Facility | | $11,975.30 | $26,221.60 | $44,272.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,305.22 / $42,003.00 / $54,464.96
| Facility | | $28,305.22 | $42,003.00 | $54,464.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,140.12 / $37,379.35 / $54,870.80
| Facility | | $26,140.12 | $37,379.35 | $54,870.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,235.41 / $36,961.30 / $77,509.00
| Facility | | $19,235.41 | $36,961.30 | $77,509.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,140.12 / $40,697.16 / $55,173.30
| Facility | | $26,140.12 | $40,697.16 | $55,173.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,573.16 / $34,419.35 / $51,743.41
| Facility | | $7,573.16 | $34,419.35 | $51,743.41 |