- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,615.70 / $30,307.70 / $39,571.00
| Facility | | $14,615.70 | $30,307.70 | $39,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,677.13 / $74,113.92
| Facility | | $5,840.42 | $27,677.13 | $74,113.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,124.84 / $28,316.31 / $42,786.28
| Facility | | $17,124.84 | $28,316.31 | $42,786.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,212.07 / $40,212.07 / $40,212.07
| Facility | | $40,212.07 | $40,212.07 | $40,212.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,673.56 / $28,526.13 / $44,051.05
| Facility | | $24,673.56 | $28,526.13 | $44,051.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,677.13 / $74,113.92
| Facility | | $5,840.42 | $27,677.13 | $74,113.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,677.13 / $57,920.70
| Facility | | $5,840.42 | $27,677.13 | $57,920.70 |