- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,003.80 / $30,003.80 / $35,560.40
| Facility | | $30,003.80 | $30,003.80 | $35,560.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,980.33 / $35,763.18 / $53,499.54
| Facility | | $21,980.33 | $35,763.18 | $53,499.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,539.42 / $30,372.73 / $51,675.68
| Facility | | $24,539.42 | $30,372.73 | $51,675.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,955.00 / $35,226.85 / $57,661.28
| Facility | | $21,955.00 | $35,226.85 | $57,661.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.33 / $20,407.00 / $29,423.21
| Facility | | $323.33 | $20,407.00 | $29,423.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,983.71 / $34,802.62 / $40,901.82
| Facility | | $24,983.71 | $34,802.62 | $40,901.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,547.80 / $37,122.08 / $46,795.42
| Facility | | $22,547.80 | $37,122.08 | $46,795.42 |