- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,063.00 / $27,104.10 / $36,357.80
| Facility | | $13,063.00 | $27,104.10 | $36,357.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,483.33 / $45,483.33 / $45,483.33
| Facility | | $45,483.33 | $45,483.33 | $45,483.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $28,429.18 / $33,803.61
| Facility | | $3,897.00 | $28,429.18 | $33,803.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,038.50 / $27,987.95 / $44,052.18
| Facility | | $23,038.50 | $27,987.95 | $44,052.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $34,578.37 / $43,670.04
| Facility | | $1,350.00 | $34,578.37 | $43,670.04 |