- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $49,155.60 / $64,470.00
| Facility | | $3,822.00 | $49,155.60 | $64,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $44,309.36 / $120,204.35
| Facility | | $5,840.42 | $44,309.36 | $120,204.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,774.55 / $45,925.83 / $69,394.47
| Facility | | $27,774.55 | $45,925.83 | $69,394.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65,219.40 / $65,219.40 / $65,219.40
| Facility | | $65,219.40 | $65,219.40 | $65,219.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,017.69 / $46,266.13 / $71,445.77
| Facility | | $40,017.69 | $46,266.13 | $71,445.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $44,309.36 / $120,204.35
| Facility | | $5,840.42 | $44,309.36 | $120,204.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $44,889.15 / $93,940.76
| Facility | | $5,840.42 | $44,889.15 | $93,940.76 |