- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,468.70 / $28,141.70 / $46,343.20
| Facility | | $11,468.70 | $28,141.70 | $46,343.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,236.92 / $44,822.84 / $57,616.16
| Facility | | $29,236.92 | $44,822.84 | $57,616.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.00 / $3,500.00 / $3,500.00
| Facility | | $3,500.00 | $3,500.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $37,191.03 / $59,464.53
| Facility | | $17,646.00 | $37,191.03 | $59,464.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,850.91 / $40,065.55 / $84,018.73
| Facility | | $20,850.91 | $40,065.55 | $84,018.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $39,800.97 / $59,479.21
| Facility | | $17,648.00 | $39,800.97 | $59,479.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $26,630.97 / $51,155.81
| Facility | | $5,281.00 | $26,630.97 | $51,155.81 |