- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,145.00 / $34,047.00 / $44,453.20
| Facility | | $4,145.00 | $34,047.00 | $44,453.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,091.90 / $83,258.00
| Facility | | $5,840.42 | $31,091.90 | $83,258.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,497.78 / $30,229.81 / $48,065.20
| Facility | | $18,497.78 | $30,229.81 | $48,065.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,173.39 / $45,173.39 / $45,173.39
| Facility | | $45,173.39 | $45,173.39 | $45,173.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,717.75 / $32,045.65 / $49,486.01
| Facility | | $27,717.75 | $32,045.65 | $49,486.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,091.90 / $83,258.00
| Facility | | $5,840.42 | $31,091.90 | $83,258.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,091.90 / $65,066.87
| Facility | | $5,840.42 | $31,091.90 | $65,066.87 |