- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,145.00 / $30,337.00 / $36,097.40
| Facility | | $4,145.00 | $30,337.00 | $36,097.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,116.39 / $84,413.89
| Facility | | $5,840.42 | $31,116.39 | $84,413.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,667.91 / $30,649.49 / $46,413.48
| Facility | | $17,667.91 | $30,649.49 | $46,413.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,800.53 / $45,800.53 / $45,800.53
| Facility | | $45,800.53 | $45,800.53 | $45,800.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,102.56 / $32,490.54 / $50,173.03
| Facility | | $28,102.56 | $32,490.54 | $50,173.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $31,116.39 / $84,413.89
| Facility | | $5,840.42 | $31,116.39 | $84,413.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,415.66 / $65,970.21
| Facility | | $5,840.42 | $22,415.66 | $65,970.21 |