- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,612.50 / $24,080.20 / $31,440.00
| Facility | | $11,612.50 | $24,080.20 | $31,440.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,706.10 / $58,885.25
| Facility | | $5,840.42 | $21,706.10 | $58,885.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,606.09 / $22,497.97 / $33,994.69
| Facility | | $13,606.09 | $22,497.97 | $33,994.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,949.43 / $31,949.43 / $31,949.43
| Facility | | $31,949.43 | $31,949.43 | $31,949.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,603.72 / $22,664.68 / $34,999.58
| Facility | | $19,603.72 | $22,664.68 | $34,999.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,706.10 / $58,885.25
| Facility | | $5,840.42 | $21,706.10 | $58,885.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,101.54 / $46,019.35
| Facility | | $5,840.42 | $17,101.54 | $46,019.35 |