- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,698.00 / $34,863.50 / $138,142.00
| Facility | | $5,698.00 | $34,863.50 | $138,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,512.87 / $24,512.87 / $24,512.87
| Facility | | $24,512.87 | $24,512.87 | $24,512.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,604.78 / $28,814.30 / $45,372.23
| Facility | | $14,604.78 | $28,814.30 | $45,372.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,942.00 / $39,357.94 / $60,326.03
| Facility | | $19,942.00 | $39,357.94 | $60,326.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,754.00 / $44,060.41 / $67,214.72
| Facility | | $19,754.00 | $44,060.41 | $67,214.72 |