- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,665.00 / $27,427.20 / $47,893.60
| Facility | | $20,665.00 | $27,427.20 | $47,893.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,582.79 / $37,582.79 / $37,582.79
| Facility | | $37,582.79 | $37,582.79 | $37,582.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,206.58 / $47,779.56
| Facility | | $5,939.30 | $24,206.58 | $47,779.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,092.75 / $31,596.00 / $48,954.00
| Facility | | $19,092.75 | $31,596.00 | $48,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $31,178.07 / $51,056.99
| Facility | | $3,496.00 | $31,178.07 | $51,056.99 |