- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,010.00 / $39,015.40 / $52,335.70
| Facility | | $8,010.00 | $39,015.40 | $52,335.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,990.61 / $39,990.61 / $39,990.61
| Facility | | $39,990.61 | $39,990.61 | $39,990.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $34,850.00 / $34,850.00
| Facility | | $3,897.00 | $34,850.00 | $34,850.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,163.06 / $40,287.60 / $63,411.45
| Facility | | $33,163.06 | $40,287.60 | $63,411.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.00 / $46,033.88 / $58,692.67
| Facility | | $2,060.00 | $46,033.88 | $58,692.67 |