- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,680.00 / $31,113.80 / $51,237.70
| Facility | | $12,680.00 | $31,113.80 | $51,237.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,495.83 / $54,157.30 / $70,225.35
| Facility | | $36,495.83 | $54,157.30 | $70,225.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $41,118.94 / $65,744.87
| Facility | | $17,646.00 | $41,118.94 | $65,744.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,053.09 / $44,297.07 / $92,892.35
| Facility | | $23,053.09 | $44,297.07 | $92,892.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,776.09 / $17,776.09 / $17,776.09
| Facility | | $17,776.09 | $17,776.09 | $17,776.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $44,004.54 / $65,761.10
| Facility | | $17,648.00 | $44,004.54 | $65,761.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $29,443.60 / $56,558.62
| Facility | | $5,281.00 | $29,443.60 | $56,558.62 |