- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $32,418.40 / $42,326.70
| Facility | | $3,822.00 | $32,418.40 | $42,326.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,604.61 / $79,275.36
| Facility | | $5,840.42 | $29,604.61 | $79,275.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,317.45 / $30,288.31 / $45,766.00
| Facility | | $18,317.45 | $30,288.31 | $45,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,012.51 / $43,012.51 / $43,012.51
| Facility | | $43,012.51 | $43,012.51 | $43,012.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,391.87 / $30,512.74 / $47,118.84
| Facility | | $26,391.87 | $30,512.74 | $47,118.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,604.61 / $79,275.36
| Facility | | $5,840.42 | $29,604.61 | $79,275.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,604.61 / $61,954.40
| Facility | | $5,840.42 | $29,604.61 | $61,954.40 |