- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $25,343.50 / $63,880.20
| Facility | | $3,821.00 | $25,343.50 | $63,880.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,020.65 / $36,020.65 / $36,020.65
| Facility | | $36,020.65 | $36,020.65 | $36,020.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,515.21 / $36,807.00 / $62,254.09
| Facility | | $13,515.21 | $36,807.00 | $62,254.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,797.37 / $51,515.70 / $91,889.46
| Facility | | $36,797.37 | $51,515.70 | $91,889.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,975.36 / $57,228.46 / $83,558.22
| Facility | | $43,975.36 | $57,228.46 | $83,558.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,975.36 / $53,201.48 / $83,558.22
| Facility | | $43,975.36 | $53,201.48 | $83,558.22 |