- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,954.00 / $33,082.90 / $43,194.40
| Facility | | $15,954.00 | $33,082.90 | $43,194.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,821.28 / $80,900.46
| Facility | | $5,840.42 | $29,821.28 | $80,900.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,692.95 / $30,909.20 / $46,704.18
| Facility | | $18,692.95 | $30,909.20 | $46,704.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,894.25 / $43,894.25 / $43,894.25
| Facility | | $43,894.25 | $43,894.25 | $43,894.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,932.89 / $31,138.24 / $48,084.75
| Facility | | $26,932.89 | $31,138.24 | $48,084.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,821.28 / $80,900.46
| Facility | | $5,840.42 | $29,821.28 | $80,900.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,495.24 / $63,224.43
| Facility | | $5,840.42 | $23,495.24 | $63,224.43 |