- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,474.00 / $31,187.10 / $54,880.40
| Facility | | $18,474.00 | $31,187.10 | $54,880.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,436.14 / $40,436.14 / $40,436.14
| Facility | | $40,436.14 | $40,436.14 | $40,436.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,868.54 / $19,327.83 / $31,953.55
| Facility | | $12,868.54 | $19,327.83 | $31,953.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,323.07 / $28,249.00 / $38,789.40
| Facility | | $16,323.07 | $28,249.00 | $38,789.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,863.70 / $56,863.70 / $66,734.38
| Facility | | $56,863.70 | $56,863.70 | $66,734.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $25,421.90 / $38,822.56
| Facility | | $1,787.00 | $25,421.90 | $38,822.56 |