- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,333.00 / $34,207.30 / $52,706.80
| Facility | | $3,333.00 | $34,207.30 | $52,706.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,893.58 / $34,868.96 / $52,243.58
| Facility | | $21,893.58 | $34,868.96 | $52,243.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,220.60 / $34,661.00 / $63,020.00
| Facility | | $25,220.60 | $34,661.00 | $63,020.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $189.06 / $364.26 / $627.36
| Facility | | $189.06 | $364.26 | $627.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,779.22 / $38,445.35 / $63,272.08
| Facility | | $27,779.22 | $38,445.35 | $63,272.08 |