- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,758.00 / $36,545.80 / $47,102.20
| Facility | | $14,758.00 | $36,545.80 | $47,102.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,133.90 / $110,148.54
| Facility | | $5,840.42 | $41,133.90 | $110,148.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,973.25 / $41,783.57 / $63,589.21
| Facility | | $21,973.25 | $41,783.57 | $63,589.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $59,763.41 / $59,763.41 / $59,763.41
| Facility | | $59,763.41 | $59,763.41 | $59,763.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,669.98 / $42,395.69 / $65,468.91
| Facility | | $36,669.98 | $42,395.69 | $65,468.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,133.90 / $110,148.54
| Facility | | $5,840.42 | $41,133.90 | $110,148.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,133.90 / $86,082.06
| Facility | | $5,840.42 | $41,133.90 | $86,082.06 |