- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,786.20 / $29,697.20 / $48,155.70
| Facility | | $18,786.20 | $29,697.20 | $48,155.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,563.84 / $26,368.62 / $60,700.44
| Facility | | $21,563.84 | $26,368.62 | $60,700.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $21,353.71 / $46,762.81
| Facility | | $100.00 | $21,353.71 | $46,762.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,061.57 / $31,170.00 / $54,678.41
| Facility | | $21,061.57 | $31,170.00 | $54,678.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,835.00 / $41,870.00 / $49,138.00
| Facility | | $28,835.00 | $41,870.00 | $49,138.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,671.81 / $26,340.21 / $55,155.32
| Facility | | $18,671.81 | $26,340.21 | $55,155.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $24,133.37 / $49,407.57
| Facility | | $5,693.00 | $24,133.37 | $49,407.57 |