- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,942.70 / $31,880.00 / $51,330.80
| Facility | | $13,942.70 | $31,880.00 | $51,330.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,789.20 / $28,789.20 / $28,789.20
| Facility | | $28,789.20 | $28,789.20 | $28,789.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,087.70 / $43,700.03
| Facility | | $1,474.01 | $11,087.70 | $43,700.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,076.99 / $33,332.55 / $47,219.57
| Facility | | $23,076.99 | $33,332.55 | $47,219.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,171.83 / $27,956.93 / $58,713.01
| Facility | | $20,171.83 | $27,956.93 | $58,713.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,504.77 / $26,507.00 / $50,403.06
| Facility | | $18,504.77 | $26,507.00 | $50,403.06 |