- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,863.80 / $32,895.69 / $42,950.00
| Facility | | $15,863.80 | $32,895.69 | $42,950.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,040.54 / $80,442.69
| Facility | | $5,840.42 | $30,040.54 | $80,442.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,587.18 / $30,734.30 / $46,439.90
| Facility | | $18,587.18 | $30,734.30 | $46,439.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,645.87 / $43,645.87 / $43,645.87
| Facility | | $43,645.87 | $43,645.87 | $43,645.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,780.49 / $30,962.04 / $47,812.66
| Facility | | $26,780.49 | $30,962.04 | $47,812.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,040.54 / $80,442.69
| Facility | | $5,840.42 | $30,040.54 | $80,442.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $30,040.54 / $62,866.67
| Facility | | $5,840.42 | $30,040.54 | $62,866.67 |