- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,738.20 / $34,363.80 / $55,722.80
| Facility | | $21,738.20 | $34,363.80 | $55,722.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,008.09 / $28,107.81 / $64,231.56
| Facility | | $16,008.09 | $28,107.81 | $64,231.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $25,915.80 / $56,843.09
| Facility | | $100.00 | $25,915.80 | $56,843.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,752.55 / $39,591.71 / $63,822.33
| Facility | | $25,752.55 | $39,591.71 | $63,822.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,346.40 / $48,420.80 / $56,825.92
| Facility | | $33,346.40 | $48,420.80 | $56,825.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,508.70 / $30,509.92 / $63,822.33
| Facility | | $21,508.70 | $30,509.92 | $63,822.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $27,925.65 / $57,171.39
| Facility | | $5,693.00 | $27,925.65 | $57,171.39 |