- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,483.00 / $38,997.00 / $79,269.50
| Facility | | $17,483.00 | $38,997.00 | $79,269.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,578.12 / $42,578.12 / $42,578.12
| Facility | | $42,578.12 | $42,578.12 | $42,578.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,526.06 / $37,011.54 / $42,313.76
| Facility | | $29,526.06 | $37,011.54 | $42,313.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,156.70 / $42,759.90 / $55,611.10
| Facility | | $24,156.70 | $42,759.90 | $55,611.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,631.61 / $45,631.61 / $45,631.61
| Facility | | $45,631.61 | $45,631.61 | $45,631.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $37,100.81 / $54,622.87
| Facility | | $1,518.00 | $37,100.81 | $54,622.87 |