- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,145.00 / $33,242.00 / $44,859.00
| Facility | | $4,145.00 | $33,242.00 | $44,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,356.80 / $81,289.57
| Facility | | $5,840.42 | $30,356.80 | $81,289.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,060.43 / $30,880.00 / $46,894.00
| Facility | | $18,060.43 | $30,880.00 | $46,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,105.37 / $44,105.37 / $44,105.37
| Facility | | $44,105.37 | $44,105.37 | $44,105.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,062.43 / $31,288.00 / $48,316.03
| Facility | | $27,062.43 | $31,288.00 | $48,316.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,356.80 / $81,289.57
| Facility | | $5,840.42 | $30,356.80 | $81,289.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,356.80 / $63,528.52
| Facility | | $5,840.42 | $30,356.80 | $63,528.52 |