- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,817.10 / $32,799.00 / $42,823.70
| Facility | | $15,817.10 | $32,799.00 | $42,823.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,952.22 / $80,206.17
| Facility | | $5,840.42 | $29,952.22 | $80,206.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,532.53 / $30,643.94 / $46,303.36
| Facility | | $18,532.53 | $30,643.94 | $46,303.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,517.55 / $43,517.55 / $43,517.55
| Facility | | $43,517.55 | $43,517.55 | $43,517.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,701.75 / $30,871.01 / $47,672.09
| Facility | | $26,701.75 | $30,871.01 | $47,672.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,952.22 / $80,206.17
| Facility | | $5,840.42 | $29,952.22 | $80,206.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,952.22 / $62,681.83
| Facility | | $5,840.42 | $29,952.22 | $62,681.83 |