- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,510.00 / $25,941.20 / $33,869.90
| Facility | | $12,510.00 | $25,941.20 | $33,869.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,689.67 / $63,436.31
| Facility | | $5,840.42 | $23,689.67 | $63,436.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,657.67 / $24,236.77 / $36,622.05
| Facility | | $14,657.67 | $24,236.77 | $36,622.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,418.69 / $34,418.69 / $34,418.69
| Facility | | $34,418.69 | $34,418.69 | $34,418.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,118.83 / $24,416.36 / $37,704.58
| Facility | | $21,118.83 | $24,416.36 | $37,704.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,689.67 / $63,436.31
| Facility | | $5,840.42 | $23,689.67 | $63,436.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,689.67 / $49,576.04
| Facility | | $5,840.42 | $23,689.67 | $49,576.04 |