- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,988.09 / $39,374.40 / $51,408.80
| Facility | | $18,988.09 | $39,374.40 | $51,408.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,956.90 / $96,285.55
| Facility | | $5,840.42 | $35,956.90 | $96,285.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,247.85 / $36,787.30 / $55,586.05
| Facility | | $22,247.85 | $36,787.30 | $55,586.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,241.75 / $52,241.75 / $52,241.75
| Facility | | $52,241.75 | $52,241.75 | $52,241.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,054.80 / $37,059.89 / $57,229.18
| Facility | | $32,054.80 | $37,059.89 | $57,229.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,956.90 / $96,285.55
| Facility | | $5,840.42 | $35,956.90 | $96,285.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,956.90 / $75,248.00
| Facility | | $5,840.42 | $35,956.90 | $75,248.00 |