- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $37,153.52 / $70,794.58
| Facility | | $19,054.61 | $37,153.52 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $22,908.68
| Facility | | $22,387.21 | $22,387.21 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $39,810.72 / $67,608.30
| Facility | | $22,908.68 | $39,810.72 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $41,686.94 / $97,723.72
| Facility | | $100.00 | $41,686.94 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $32,359.37 / $56,234.13
| Facility | | $22,387.21 | $32,359.37 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $57,543.99 / $57,543.99 / $57,543.99
| Facility | | $57,543.99 | $57,543.99 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $36,307.81 / $64,565.42
| Facility | | $22,387.21 | $36,307.81 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $31,622.78 / $63,095.73
| Facility | | $5,754.40 | $31,622.78 | $63,095.73 |