- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,597.00 / $58,981.30 / $81,593.80
| Facility | | $17,597.00 | $58,981.30 | $81,593.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $22,766.66
| Facility | | $1,146.00 | $3,000.00 | $22,766.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,199.78 / $30,673.33 / $56,894.62
| Facility | | $22,199.78 | $30,673.33 | $56,894.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,199.78 / $31,674.60 / $56,894.62
| Facility | | $22,199.78 | $31,674.60 | $56,894.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $39,258.91 / $60,871.54
| Facility | | $5,419.00 | $39,258.91 | $60,871.54 |