- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.40 / $27,594.80 / $36,029.00
| Facility | | $13,307.40 | $27,594.80 | $36,029.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,199.75 / $67,480.00
| Facility | | $5,840.42 | $25,199.75 | $67,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,592.00 / $25,781.72 / $38,956.48
| Facility | | $15,592.00 | $25,781.72 | $38,956.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,535.47 / $31,535.47 / $31,535.47
| Facility | | $31,535.47 | $31,535.47 | $31,535.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,465.03 / $25,972.76 / $40,108.04
| Facility | | $22,465.03 | $25,972.76 | $40,108.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,199.75 / $67,480.00
| Facility | | $5,840.42 | $25,199.75 | $67,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,199.75 / $52,736.22
| Facility | | $5,840.42 | $25,199.75 | $52,736.22 |