- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,503.80 / $26,115.40 / $26,115.40
| Facility | | $23,503.80 | $26,115.40 | $26,115.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,706.00 / $28,706.00 / $28,706.00
| Facility | | $28,706.00 | $28,706.00 | $28,706.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,675.40 / $14,389.42 / $31,854.17
| Facility | | $6,675.40 | $14,389.42 | $31,854.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,952.00 / $28,753.88 / $45,188.73
| Facility | | $7,952.00 | $28,753.88 | $45,188.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,373.00 / $39,015.73 / $61,277.47
| Facility | | $19,373.00 | $39,015.73 | $61,277.47 |