- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,853.00 / $43,241.60 / $56,458.10
| Facility | | $20,853.00 | $43,241.60 | $56,458.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,488.49 / $105,742.44
| Facility | | $5,840.42 | $39,488.49 | $105,742.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,432.97 / $40,112.16 / $61,045.55
| Facility | | $24,432.97 | $40,112.16 | $61,045.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,372.79 / $57,372.79 / $57,372.79
| Facility | | $57,372.79 | $57,372.79 | $57,372.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,203.12 / $40,699.81 / $62,850.06
| Facility | | $35,203.12 | $40,699.81 | $62,850.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,488.49 / $105,742.44
| Facility | | $5,840.42 | $39,488.49 | $105,742.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $39,488.49 / $82,638.64
| Facility | | $5,840.42 | $39,488.49 | $82,638.64 |