- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $29,872.90 / $36,537.40
| Facility | | $3,000.00 | $29,872.90 | $36,537.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,205.13 / $32,205.13 / $43,828.51
| Facility | | $32,205.13 | $32,205.13 | $43,828.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $40,107.69 / $47,689.91
| Facility | | $3,897.00 | $40,107.69 | $47,689.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,810.27 / $33,784.85 / $53,176.32
| Facility | | $27,810.27 | $33,784.85 | $53,176.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $41,740.29 / $52,715.03
| Facility | | $1,350.00 | $41,740.29 | $52,715.03 |