- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,567.00 / $28,133.00 / $36,731.69
| Facility | | $13,567.00 | $28,133.00 | $36,731.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,691.24 / $68,796.10
| Facility | | $5,840.42 | $25,691.24 | $68,796.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,896.11 / $26,284.56 / $39,716.28
| Facility | | $15,896.11 | $26,284.56 | $39,716.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,326.76 / $37,326.76 / $37,326.76
| Facility | | $37,326.76 | $37,326.76 | $37,326.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,903.18 / $26,479.32 / $40,890.29
| Facility | | $22,903.18 | $26,479.32 | $40,890.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,691.24 / $68,796.10
| Facility | | $5,840.42 | $25,691.24 | $68,796.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,691.24 / $53,764.76
| Facility | | $5,840.42 | $25,691.24 | $53,764.76 |