- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,947.70 / $24,687.70 / $40,032.40
| Facility | | $15,947.70 | $24,687.70 | $40,032.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,268.00 / $13,268.00 / $35,564.00
| Facility | | $13,268.00 | $13,268.00 | $35,564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,211.89 / $22,269.80 / $46,908.16
| Facility | | $18,211.89 | $22,269.80 | $46,908.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,712.66 / $41,754.67
| Facility | | $100.00 | $17,712.66 | $41,754.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,627.91 / $25,581.62 / $45,454.83
| Facility | | $16,627.91 | $25,581.62 | $45,454.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,352.80 / $35,361.60 / $41,499.83
| Facility | | $24,352.80 | $35,361.60 | $41,499.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,855.61 / $21,918.96 / $45,851.28
| Facility | | $15,855.61 | $21,918.96 | $45,851.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $20,062.37 / $41,073.11
| Facility | | $5,693.00 | $20,062.37 | $41,073.11 |