- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,626.40 / $28,256.30 / $36,892.60
| Facility | | $13,626.40 | $28,256.30 | $36,892.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,470.50 / $69,097.47
| Facility | | $5,840.42 | $25,470.50 | $69,097.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,965.74 / $26,399.70 / $39,890.26
| Facility | | $15,965.74 | $26,399.70 | $39,890.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,859.00 / $36,859.00 / $36,859.00
| Facility | | $36,859.00 | $36,859.00 | $36,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,003.51 / $26,595.32 / $41,069.42
| Facility | | $23,003.51 | $26,595.32 | $41,069.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,470.50 / $69,097.47
| Facility | | $5,840.42 | $25,470.50 | $69,097.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,067.39 / $54,000.29
| Facility | | $5,840.42 | $20,067.39 | $54,000.29 |