- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $44,668.36 / $72,443.60
| Facility | | $28,183.83 | $44,668.36 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,738.03 / $40,738.03 / $56,234.13
| Facility | | $40,738.03 | $40,738.03 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $30,199.52 / $53,703.18
| Facility | | $14,791.08 | $30,199.52 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $52,480.75 / $93,325.43
| Facility | | $28,183.83 | $52,480.75 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112,201.85 / $131,825.67 / $131,825.67
| Facility | | $112,201.85 | $131,825.67 | $131,825.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $43,651.58 / $72,443.60
| Facility | | $21,877.62 | $43,651.58 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $39,810.72 / $100,000.00
| Facility | | $27,542.29 | $39,810.72 | $100,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $41,686.94 / $87,096.36
| Facility | | $14,791.08 | $41,686.94 | $87,096.36 |