- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,850.20 / $31,887.00 / $52,940.00
| Facility | | $24,850.20 | $31,887.00 | $52,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,503.40 / $42,503.40 / $42,503.40
| Facility | | $42,503.40 | $42,503.40 | $42,503.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,894.64 / $28,654.65 / $47,949.75
| Facility | | $18,894.64 | $28,654.65 | $47,949.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,674.26 / $34,011.21 / $48,903.96
| Facility | | $27,674.26 | $34,011.21 | $48,903.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,086.25 / $34,350.19 / $54,736.14
| Facility | | $17,086.25 | $34,350.19 | $54,736.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,432.87 / $34,350.19 / $45,818.49
| Facility | | $16,432.87 | $34,350.19 | $45,818.49 |