- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,348.30 / $25,605.80 / $33,432.00
| Facility | | $12,348.30 | $25,605.80 | $33,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,383.38 / $62,616.13
| Facility | | $5,840.42 | $23,383.38 | $62,616.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,468.15 / $23,923.41 / $36,148.55
| Facility | | $14,468.15 | $23,923.41 | $36,148.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,973.69 / $33,973.69 / $33,973.69
| Facility | | $33,973.69 | $33,973.69 | $33,973.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,845.78 / $24,100.68 / $37,217.10
| Facility | | $20,845.78 | $24,100.68 | $37,217.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,383.38 / $62,616.13
| Facility | | $5,840.42 | $23,383.38 | $62,616.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $23,383.38 / $48,935.06
| Facility | | $5,840.42 | $23,383.38 | $48,935.06 |