- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $38,084.30 / $49,724.40
| Facility | | $3,822.00 | $38,084.30 | $49,724.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $34,778.76 / $93,130.71
| Facility | | $5,840.42 | $34,778.76 | $93,130.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,518.89 / $35,581.94 / $53,764.75
| Facility | | $21,518.89 | $35,581.94 | $53,764.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,530.03 / $50,530.03 / $50,530.03
| Facility | | $50,530.03 | $50,530.03 | $50,530.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,004.51 / $35,845.61 / $55,354.04
| Facility | | $31,004.51 | $35,845.61 | $55,354.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $34,778.76 / $93,130.71
| Facility | | $5,840.42 | $34,778.76 | $93,130.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $34,778.76 / $72,782.48
| Facility | | $5,840.42 | $34,778.76 | $72,782.48 |