- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,750.00 / $49,048.60 / $59,225.00
| Facility | | $25,750.00 | $49,048.60 | $59,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $44,290.00 / $77,168.32
| Facility | | $6,916.00 | $44,290.00 | $77,168.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,253.80 / $39,885.44 / $44,816.86
| Facility | | $27,253.80 | $39,885.44 | $44,816.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,469.43 / $32,859.30 / $48,485.53
| Facility | | $19,469.43 | $32,859.30 | $48,485.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,982.65 / $44,290.00 / $68,376.85
| Facility | | $24,982.65 | $44,290.00 | $68,376.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,729.24 / $21,729.24 / $50,130.88
| Facility | | $21,729.24 | $21,729.24 | $50,130.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $40,384.24 / $58,174.40
| Facility | | $3,775.00 | $40,384.24 | $58,174.40 |