- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,415.40 / $31,966.00 / $41,736.10
| Facility | | $15,415.40 | $31,966.00 | $41,736.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,191.48 / $78,169.07
| Facility | | $5,840.42 | $29,191.48 | $78,169.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,061.83 / $29,865.63 / $45,127.33
| Facility | | $18,061.83 | $29,865.63 | $45,127.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,412.27 / $42,412.27 / $42,412.27
| Facility | | $42,412.27 | $42,412.27 | $42,412.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,023.57 / $30,086.94 / $46,461.29
| Facility | | $26,023.57 | $30,086.94 | $46,461.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,191.48 / $78,169.07
| Facility | | $5,840.42 | $29,191.48 | $78,169.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $29,191.48 / $61,089.82
| Facility | | $5,840.42 | $29,191.48 | $61,089.82 |