- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $39,826.80 / $53,191.80
| Facility | | $3,822.00 | $39,826.80 | $53,191.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,900.29 / $97,391.84
| Facility | | $5,840.42 | $35,900.29 | $97,391.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,637.95 / $37,209.98 / $56,937.01
| Facility | | $21,637.95 | $37,209.98 | $56,937.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,841.99 / $52,841.99 / $52,841.99
| Facility | | $52,841.99 | $52,841.99 | $52,841.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,423.10 / $37,485.69 / $57,886.72
| Facility | | $32,423.10 | $37,485.69 | $57,886.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,900.29 / $97,391.84
| Facility | | $5,840.42 | $35,900.29 | $97,391.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $35,900.29 / $76,112.59
| Facility | | $5,840.42 | $35,900.29 | $76,112.59 |