- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,586.00 / $42,155.80 / $48,603.10
| Facility | | $22,586.00 | $42,155.80 | $48,603.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,335.46 / $42,335.46 / $42,335.46
| Facility | | $42,335.46 | $42,335.46 | $42,335.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $14,552.00
| Facility | | $1,252.00 | $3,715.00 | $14,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,463.52 / $51,216.21 / $84,498.22
| Facility | | $31,463.52 | $51,216.21 | $84,498.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,121.00 / $48,432.18 / $73,187.35
| Facility | | $5,121.00 | $48,432.18 | $73,187.35 |