- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.00 / $31,236.48 / $40,698.50
| Facility | | $4,002.00 | $31,236.48 | $40,698.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,812.00 / $5,812.00 / $6,916.00
| Facility | | $5,812.00 | $5,812.00 | $6,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,383.00 / $28,534.60 / $35,003.74
| Facility | | $22,383.00 | $28,534.60 | $35,003.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $26,386.80 / $35,182.40
| Facility | | $2,400.00 | $26,386.80 | $35,182.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,735.66 / $31,491.83 / $49,390.16
| Facility | | $15,735.66 | $31,491.83 | $49,390.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,143.00 / $27,202.39
| Facility | | $1,500.00 | $2,143.00 | $27,202.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,751.42 / $39,976.54
| Facility | | $3,775.00 | $27,751.42 | $39,976.54 |