- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,967.20 / $45,552.00 / $59,474.60
| Facility | | $21,967.20 | $45,552.00 | $59,474.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,598.32 / $111,392.16
| Facility | | $5,840.42 | $41,598.32 | $111,392.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,738.40 / $42,559.00 / $64,307.16
| Facility | | $25,738.40 | $42,559.00 | $64,307.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,438.16 / $60,438.16 / $60,438.16
| Facility | | $60,438.16 | $60,438.16 | $60,438.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,084.00 / $42,874.36 / $66,208.08
| Facility | | $37,084.00 | $42,874.36 | $66,208.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,598.32 / $111,392.16
| Facility | | $5,840.42 | $41,598.32 | $111,392.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,598.32 / $87,053.96
| Facility | | $5,840.42 | $41,598.32 | $87,053.96 |