- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,236.88 / $43,936.80 / $91,376.00
| Facility | | $31,236.88 | $43,936.80 | $91,376.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,259.40 / $16,259.40 / $33,686.94
| Facility | | $16,259.40 | $16,259.40 | $33,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,584.79 / $40,697.08 / $68,784.08
| Facility | | $26,584.79 | $40,697.08 | $68,784.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,356.00 / $43,782.51 / $67,314.95
| Facility | | $33,356.00 | $43,782.51 | $67,314.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,619.39 / $45,998.91 / $75,342.78
| Facility | | $22,619.39 | $45,998.91 | $75,342.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,619.39 / $44,971.61 / $63,067.88
| Facility | | $22,619.39 | $44,971.61 | $63,067.88 |