- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,687.00 / $32,529.10 / $42,471.40
| Facility | | $15,687.00 | $32,529.10 | $42,471.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,322.08 / $79,546.21
| Facility | | $5,840.42 | $29,322.08 | $79,546.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,380.04 / $30,391.79 / $45,922.36
| Facility | | $18,380.04 | $30,391.79 | $45,922.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,159.47 / $43,159.47 / $43,159.47
| Facility | | $43,159.47 | $43,159.47 | $43,159.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,482.04 / $30,616.99 / $47,279.82
| Facility | | $26,482.04 | $30,616.99 | $47,279.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,322.08 / $79,546.21
| Facility | | $5,840.42 | $29,322.08 | $79,546.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,101.93 / $62,166.07
| Facility | | $5,840.42 | $23,101.93 | $62,166.07 |