- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,414.09 / $32,774.30 / $57,673.30
| Facility | | $19,414.09 | $32,774.30 | $57,673.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $2,628.00 / $9,306.00
| Facility | | $2,628.00 | $2,628.00 | $9,306.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,349.08 / $13,800.16 / $22,817.79
| Facility | | $9,349.08 | $13,800.16 | $22,817.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,153.77 / $29,709.03 / $40,763.44
| Facility | | $17,153.77 | $29,709.03 | $40,763.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,358.64 / $66,358.64 / $77,877.50
| Facility | | $66,358.64 | $66,358.64 | $77,877.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $28,562.51 / $40,798.28
| Facility | | $1,787.00 | $28,562.51 | $40,798.28 |