- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,083.30 / $24,268.50 / $40,974.90
| Facility | | $11,083.30 | $24,268.50 | $40,974.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,082.00 / $37,002.83 / $47,981.30
| Facility | | $25,082.00 | $37,002.83 | $47,981.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,193.07 / $34,595.15 / $50,783.74
| Facility | | $24,193.07 | $34,595.15 | $50,783.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,802.65 / $34,208.23 / $71,735.74
| Facility | | $17,802.65 | $34,208.23 | $71,735.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,193.07 / $37,665.83 / $51,063.71
| Facility | | $24,193.07 | $37,665.83 | $51,063.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,009.07 / $31,855.62 / $47,889.29
| Facility | | $7,009.07 | $31,855.62 | $47,889.29 |