- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,614.40 / $28,231.30 / $36,860.00
| Facility | | $13,614.40 | $28,231.30 | $36,860.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,448.00 / $69,036.44
| Facility | | $5,840.42 | $25,448.00 | $69,036.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,951.64 / $26,376.38 / $39,855.01
| Facility | | $15,951.64 | $26,376.38 | $39,855.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,457.17 / $37,457.17 / $37,457.17
| Facility | | $37,457.17 | $37,457.17 | $37,457.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,983.19 / $26,571.83 / $41,033.14
| Facility | | $22,983.19 | $26,571.83 | $41,033.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $25,448.00 / $69,036.44
| Facility | | $5,840.42 | $25,448.00 | $69,036.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,049.66 / $53,952.59
| Facility | | $5,840.42 | $20,049.66 | $53,952.59 |