- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,493.80 / $30,055.00 / $39,241.00
| Facility | | $14,493.80 | $30,055.00 | $39,241.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,446.34 / $73,495.94
| Facility | | $5,840.42 | $27,446.34 | $73,495.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.05 / $28,080.20 / $42,429.51
| Facility | | $16,982.05 | $28,080.20 | $42,429.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,876.76 / $39,876.76 / $39,876.76
| Facility | | $39,876.76 | $39,876.76 | $39,876.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,467.82 / $28,288.27 / $43,683.73
| Facility | | $24,467.82 | $28,288.27 | $43,683.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,446.34 / $73,495.94
| Facility | | $5,840.42 | $27,446.34 | $73,495.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $27,446.34 / $57,437.73
| Facility | | $5,840.42 | $27,446.34 | $57,437.73 |