- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,468.80 / $23,782.20 / $31,051.00
| Facility | | $11,468.80 | $23,782.20 | $31,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,718.03 / $58,156.63
| Facility | | $5,840.42 | $21,718.03 | $58,156.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,437.74 / $22,219.59 / $33,574.06
| Facility | | $13,437.74 | $22,219.59 | $33,574.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,554.10 / $31,554.10 / $31,554.10
| Facility | | $31,554.10 | $31,554.10 | $31,554.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,361.15 / $22,384.23 / $34,566.51
| Facility | | $19,361.15 | $22,384.23 | $34,566.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,718.03 / $58,156.63
| Facility | | $5,840.42 | $21,718.03 | $58,156.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,718.03 / $45,449.92
| Facility | | $5,840.42 | $21,718.03 | $45,449.92 |