- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $37,892.40 / $68,867.80
| Facility | | $3,182.00 | $37,892.40 | $68,867.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,239.55 / $37,239.55 / $37,239.55
| Facility | | $37,239.55 | $37,239.55 | $37,239.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $22,766.45 / $58,647.84
| Facility | | $1,474.01 | $22,766.45 | $58,647.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,832.88 / $42,359.09 / $63,351.93
| Facility | | $28,832.88 | $42,359.09 | $63,351.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,063.44 / $45,762.47 / $78,772.05
| Facility | | $27,063.44 | $45,762.47 | $78,772.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,063.44 / $45,762.47 / $70,557.00
| Facility | | $27,063.44 | $45,762.47 | $70,557.00 |