- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,767.10 / $28,548.00 / $37,273.40
| Facility | | $13,767.10 | $28,548.00 | $37,273.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,070.18 / $69,810.84
| Facility | | $5,840.42 | $26,070.18 | $69,810.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,130.57 / $26,672.25 / $40,302.08
| Facility | | $16,130.57 | $26,672.25 | $40,302.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,877.33 / $37,877.33 / $37,877.33
| Facility | | $37,877.33 | $37,877.33 | $37,877.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,241.00 / $26,869.89 / $41,493.42
| Facility | | $23,241.00 | $26,869.89 | $41,493.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,070.18 / $69,810.84
| Facility | | $5,840.42 | $26,070.18 | $69,810.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $26,070.18 / $54,557.79
| Facility | | $5,840.42 | $26,070.18 | $54,557.79 |