- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,895.10 / $23,546.30 / $38,181.60
| Facility | | $14,895.10 | $23,546.30 | $38,181.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,128.63 / $21,120.85 / $48,265.06
| Facility | | $16,128.63 | $21,120.85 | $48,265.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,786.25 / $33,446.28
| Facility | | $100.00 | $17,786.25 | $33,446.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,011.12 / $25,703.80 / $45,520.72
| Facility | | $17,011.12 | $25,703.80 | $45,520.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,057.25 / $36,384.50 / $42,700.30
| Facility | | $25,057.25 | $36,384.50 | $42,700.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,294.18 / $20,878.18 / $45,520.72
| Facility | | $16,294.18 | $20,878.18 | $45,520.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $19,134.81 / $39,174.16
| Facility | | $5,693.00 | $19,134.81 | $39,174.16 |