- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,552.00 / $31,472.40 / $41,365.50
| Facility | | $21,552.00 | $31,472.40 | $41,365.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,465.68 / $23,130.56 / $35,153.85
| Facility | | $17,465.68 | $23,130.56 | $35,153.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,116.45 / $24,827.55 / $41,992.45
| Facility | | $9,116.45 | $24,827.55 | $41,992.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,893.92 / $31,612.25 / $52,911.76
| Facility | | $21,893.92 | $31,612.25 | $52,911.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,109.53 / $35,279.69 / $51,511.22
| Facility | | $27,109.53 | $35,279.69 | $51,511.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,109.53 / $32,797.17 / $51,511.22
| Facility | | $27,109.53 | $32,797.17 | $51,511.22 |