- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $13,783.32 / $33,044.47
| Facility | | $5,463.36 | $13,783.32 | $33,044.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,731.81 / $33,844.37 / $65,465.93
| Facility | | $25,731.81 | $33,844.37 | $65,465.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,855.00 / $36,855.00 / $36,855.00
| Facility | | $36,855.00 | $36,855.00 | $36,855.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.33 / $1,667.11 / $26,581.96
| Facility | | $1,079.33 | $1,667.11 | $26,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,697.65 / $2,109.69 / $2,435.62
| Facility | | $1,697.65 | $2,109.69 | $2,435.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,617.00 / $11,459.00 / $26,782.00
| Facility | | $9,617.00 | $11,459.00 | $26,782.00 |