- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,592.50 / $44,775.10 / $58,460.20
| Facility | | $21,592.50 | $44,775.10 | $58,460.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $40,888.87 / $109,492.39
| Facility | | $5,840.42 | $40,888.87 | $109,492.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,299.44 / $42,931.00 / $63,210.41
| Facility | | $25,299.44 | $42,931.00 | $63,210.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,717.00 / $21,717.00 / $59,407.40
| Facility | | $21,717.00 | $21,717.00 | $59,407.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,451.54 / $42,143.15 / $65,078.91
| Facility | | $36,451.54 | $42,143.15 | $65,078.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $40,888.87 / $109,492.39
| Facility | | $5,840.42 | $40,888.87 | $109,492.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,750.00 / $40,888.87 / $95,296.38
| Facility | | $9,750.00 | $40,888.87 | $95,296.38 |