- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,443.20 / $38,888.30 / $52,185.00
| Facility | | $23,443.20 | $38,888.30 | $52,185.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,669.68 / $37,669.68 / $37,669.68
| Facility | | $37,669.68 | $37,669.68 | $37,669.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,760.84 / $31,668.31 / $50,670.52
| Facility | | $18,760.84 | $31,668.31 | $50,670.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,250.00 / $31,311.00 / $71,808.64
| Facility | | $19,250.00 | $31,311.00 | $71,808.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,719.26 / $30,843.42 / $43,693.46
| Facility | | $22,719.26 | $30,843.42 | $43,693.46 |