- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,665.50 / $36,575.00 / $64,361.40
| Facility | | $21,665.50 | $36,575.00 | $64,361.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,430.99 / $27,840.75 / $45,644.13
| Facility | | $19,430.99 | $27,840.75 | $45,644.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,708.18 / $33,154.26 / $45,490.60
| Facility | | $19,708.18 | $33,154.26 | $45,490.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,675.70 / $67,675.70 / $79,423.17
| Facility | | $67,675.70 | $67,675.70 | $79,423.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $31,874.79 / $45,529.49
| Facility | | $1,787.00 | $31,874.79 | $45,529.49 |