- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,151.00 / $27,270.40 / $35,605.30
| Facility | | $13,151.00 | $27,270.40 | $35,605.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,903.43 / $66,686.52
| Facility | | $5,840.42 | $24,903.43 | $66,686.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,408.66 / $25,478.56 / $38,498.41
| Facility | | $15,408.66 | $25,478.56 | $38,498.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,182.17 / $36,182.17 / $36,182.17
| Facility | | $36,182.17 | $36,182.17 | $36,182.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,200.87 / $25,667.35 / $39,636.42
| Facility | | $22,200.87 | $25,667.35 | $39,636.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,903.43 / $66,686.52
| Facility | | $5,840.42 | $24,903.43 | $66,686.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,903.43 / $52,116.11
| Facility | | $5,840.42 | $24,903.43 | $52,116.11 |