- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,640.00 / $48,798.10 / $69,092.80
| Facility | | $26,640.00 | $48,798.10 | $69,092.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,285.58 / $46,696.66 / $73,652.19
| Facility | | $29,285.58 | $46,696.66 | $73,652.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,697.56 / $43,896.44 / $78,098.73
| Facility | | $27,697.56 | $43,896.44 | $78,098.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $42,792.73 / $92,351.89
| Facility | | $7,117.00 | $42,792.73 | $92,351.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $40,513.98 / $82,068.71
| Facility | | $3,308.00 | $40,513.98 | $82,068.71 |