- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,511.10 / $30,090.80 / $39,287.80
| Facility | | $14,511.10 | $30,090.80 | $39,287.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,479.11 / $73,583.67
| Facility | | $5,840.42 | $27,479.11 | $73,583.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,057.25 / $29,307.71 / $42,931.00
| Facility | | $17,057.25 | $29,307.71 | $42,931.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,717.00 / $21,717.00 / $39,924.37
| Facility | | $21,717.00 | $21,717.00 | $39,924.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,497.03 / $28,322.04 / $43,735.88
| Facility | | $24,497.03 | $28,322.04 | $43,735.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,479.11 / $73,583.67
| Facility | | $5,840.42 | $27,479.11 | $73,583.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,479.11 / $57,506.30
| Facility | | $5,840.42 | $27,479.11 | $57,506.30 |