- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,431.00 / $29,426.50 / $51,782.10
| Facility | | $17,431.00 | $29,426.50 | $51,782.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,971.24 / $45,716.59 / $75,809.42
| Facility | | $30,971.24 | $45,716.59 | $75,809.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,856.25 / $26,674.32 / $36,599.53
| Facility | | $15,856.25 | $26,674.32 | $36,599.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,912.34 / $56,601.35 / $66,426.49
| Facility | | $26,912.34 | $56,601.35 | $66,426.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $25,644.91 / $36,630.82
| Facility | | $1,787.00 | $25,644.91 | $36,630.82 |