- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,379.90 / $28,121.00 / $47,064.60
| Facility | | $20,379.90 | $28,121.00 | $47,064.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,335.61 / $38,335.61 / $38,335.61
| Facility | | $38,335.61 | $38,335.61 | $38,335.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $31,280.13 / $48,718.09
| Facility | | $2,423.00 | $31,280.13 | $48,718.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,858.64 / $31,637.32 / $53,055.59
| Facility | | $20,858.64 | $31,637.32 | $53,055.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $25,533.07 / $56,775.73
| Facility | | $2,600.00 | $25,533.07 | $56,775.73 |