- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,408.50 / $31,544.80 / $38,726.00
| Facility | | $13,408.50 | $31,544.80 | $38,726.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,806.84 / $77,139.07
| Facility | | $5,840.42 | $28,806.84 | $77,139.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,823.84 / $29,472.11 / $44,532.71
| Facility | | $17,823.84 | $29,472.11 | $44,532.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,853.43 / $41,853.43 / $41,853.43
| Facility | | $41,853.43 | $41,853.43 | $41,853.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,680.67 / $29,690.49 / $45,849.10
| Facility | | $25,680.67 | $29,690.49 | $45,849.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,806.84 / $77,139.07
| Facility | | $5,840.42 | $28,806.84 | $77,139.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,806.84 / $67,137.75
| Facility | | $5,840.42 | $28,806.84 | $67,137.75 |