- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,128.80 / $31,371.60 / $40,960.00
| Facility | | $15,128.80 | $31,371.60 | $40,960.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,278.68 / $76,715.63
| Facility | | $5,840.42 | $28,278.68 | $76,715.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,726.00 / $29,310.33 / $44,288.25
| Facility | | $17,726.00 | $29,310.33 | $44,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,623.68 / $41,623.68 / $41,623.68
| Facility | | $41,623.68 | $41,623.68 | $41,623.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,539.70 / $29,527.51 / $45,597.41
| Facility | | $25,539.70 | $29,527.51 | $45,597.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,278.68 / $76,715.63
| Facility | | $5,840.42 | $28,278.68 | $76,715.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,279.87 / $59,953.94
| Facility | | $5,840.42 | $22,279.87 | $59,953.94 |