- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,222.90 / $23,764.90 / $39,774.10
| Facility | | $17,222.90 | $23,764.90 | $39,774.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,062.71 / $32,062.71 / $32,062.71
| Facility | | $32,062.71 | $32,062.71 | $32,062.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $26,785.68 / $41,254.29
| Facility | | $2,423.00 | $26,785.68 | $41,254.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,627.54 / $26,736.56 / $44,837.05
| Facility | | $17,627.54 | $26,736.56 | $44,837.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $21,577.88 / $48,136.75
| Facility | | $2,600.00 | $21,577.88 | $48,136.75 |