- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,501.20 / $27,156.60 / $47,513.80
| Facility | | $20,501.20 | $27,156.60 | $47,513.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,775.00 / $16,491.00 / $29,815.47
| Facility | | $13,775.00 | $16,491.00 | $29,815.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $23,220.88 / $45,349.26
| Facility | | $5,939.30 | $23,220.88 | $45,349.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,930.00 / $26,054.51 / $42,421.50
| Facility | | $15,930.00 | $26,054.51 | $42,421.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $27,986.19 / $48,072.56
| Facility | | $3,496.00 | $27,986.19 | $48,072.56 |