- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,339.00 / $27,660.40 / $36,114.50
| Facility | | $13,339.00 | $27,660.40 | $36,114.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,933.33 / $67,640.22
| Facility | | $5,840.42 | $24,933.33 | $67,640.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,629.03 / $25,842.93 / $39,048.98
| Facility | | $15,629.03 | $25,842.93 | $39,048.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,699.62 / $36,699.62 / $36,699.62
| Facility | | $36,699.62 | $36,699.62 | $36,699.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,518.37 / $26,034.43 / $40,203.26
| Facility | | $22,518.37 | $26,034.43 | $40,203.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,933.33 / $67,640.22
| Facility | | $5,840.42 | $24,933.33 | $67,640.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,644.16 / $52,861.43
| Facility | | $5,840.42 | $19,644.16 | $52,861.43 |