- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,160.00 / $27,289.10 / $35,629.69
| Facility | | $13,160.00 | $27,289.10 | $35,629.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,920.53 / $66,732.30
| Facility | | $5,840.42 | $24,920.53 | $66,732.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,419.24 / $25,496.05 / $38,524.83
| Facility | | $15,419.24 | $25,496.05 | $38,524.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,207.01 / $36,207.01 / $36,207.01
| Facility | | $36,207.01 | $36,207.01 | $36,207.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,216.11 / $25,684.97 / $39,663.62
| Facility | | $22,216.11 | $25,684.97 | $39,663.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,920.53 / $66,732.30
| Facility | | $5,840.42 | $24,920.53 | $66,732.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,920.53 / $52,151.88
| Facility | | $5,840.42 | $24,920.53 | $52,151.88 |