- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,023.50 / $35,321.60 / $47,380.80
| Facility | | $17,023.50 | $35,321.60 | $47,380.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,035.48 / $28,035.48 / $36,473.37
| Facility | | $28,035.48 | $28,035.48 | $36,473.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $35,715.83 / $42,467.78
| Facility | | $3,897.00 | $35,715.83 | $42,467.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,023.33 / $36,473.35 / $57,407.94
| Facility | | $30,023.33 | $36,473.35 | $57,407.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $45,061.86 / $56,909.94
| Facility | | $1,350.00 | $45,061.86 | $56,909.94 |