- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,183.80 / $61,296.60 / $107,036.00
| Facility | | $46,183.80 | $61,296.60 | $107,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,786.00 / $18,786.00 / $18,786.00
| Facility | | $18,786.00 | $18,786.00 | $18,786.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $52,507.63 / $102,542.84
| Facility | | $5,939.30 | $52,507.63 | $102,542.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,290.47 / $58,694.10 / $95,564.70
| Facility | | $39,290.47 | $58,694.10 | $95,564.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $58,786.00 / $108,295.08
| Facility | | $3,496.00 | $58,786.00 | $108,295.08 |