- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,626.00 / $35,830.00 / $71,898.00
| Facility | | $5,626.00 | $35,830.00 | $71,898.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,931.57 / $61,848.52 / $83,327.52
| Facility | | $40,931.57 | $61,848.52 | $83,327.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $47,536.30 / $76,005.53
| Facility | | $17,646.00 | $47,536.30 | $76,005.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,650.94 / $51,210.43 / $107,389.89
| Facility | | $26,650.94 | $51,210.43 | $107,389.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,806.81 / $19,806.81 / $19,806.81
| Facility | | $19,806.81 | $19,806.81 | $19,806.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $50,872.25 / $76,024.31
| Facility | | $17,648.00 | $50,872.25 | $76,024.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $34,038.80 / $65,385.62
| Facility | | $5,281.00 | $34,038.80 | $65,385.62 |