- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,497.40 / $32,136.00 / $41,958.10
| Facility | | $15,497.40 | $32,136.00 | $41,958.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,967.72 / $78,584.88
| Facility | | $5,840.42 | $28,967.72 | $78,584.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,157.91 / $30,024.50 / $45,367.38
| Facility | | $18,157.91 | $30,024.50 | $45,367.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,637.88 / $42,637.88 / $42,637.88
| Facility | | $42,637.88 | $42,637.88 | $42,637.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,162.00 / $30,246.98 / $46,708.44
| Facility | | $26,162.00 | $30,246.98 | $46,708.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $28,967.72 / $78,584.88
| Facility | | $5,840.42 | $28,967.72 | $78,584.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,822.74 / $61,414.78
| Facility | | $5,840.42 | $22,822.74 | $61,414.78 |