- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $26,819.50 / $32,802.80
| Facility | | $3,000.00 | $26,819.50 | $32,802.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,157.83 / $40,157.83 / $40,157.83
| Facility | | $40,157.83 | $40,157.83 | $40,157.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $46,535.87 / $55,333.31
| Facility | | $3,897.00 | $46,535.87 | $55,333.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,967.70 / $30,331.60 / $47,741.01
| Facility | | $24,967.70 | $30,331.60 | $47,741.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $37,473.89 / $51,378.00
| Facility | | $1,350.00 | $37,473.89 | $51,378.00 |