- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,406.00 / $29,361.50 / $47,275.80
| Facility | | $3,406.00 | $29,361.50 | $47,275.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $16,212.50 / $41,753.62
| Facility | | $1,474.01 | $16,212.50 | $41,753.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,792.96 / $29,078.32 / $43,489.32
| Facility | | $19,792.96 | $29,078.32 | $43,489.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,578.29 / $31,414.65 / $54,074.80
| Facility | | $18,578.29 | $31,414.65 | $54,074.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,578.29 / $31,414.65 / $46,421.32
| Facility | | $18,578.29 | $31,414.65 | $46,421.32 |