- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,869.10 / $34,410.30 / $56,666.30
| Facility | | $11,869.10 | $34,410.30 | $56,666.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,369.00 / $54,121.87 / $69,569.30
| Facility | | $35,369.00 | $54,121.87 | $69,569.30 |
- 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 / $45,475.46 / $72,710.46
| Facility | | $17,646.00 | $45,475.46 | $72,710.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,495.54 / $48,990.29 / $102,734.19
| Facility | | $25,495.54 | $48,990.29 | $102,734.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $48,666.78 / $72,728.41
| Facility | | $17,648.00 | $48,666.78 | $72,728.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $32,563.12 / $62,550.94
| Facility | | $5,281.00 | $32,563.12 | $62,550.94 |