- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,827.09 / $29,762.00 / $40,361.10
| Facility | | $18,827.09 | $29,762.00 | $40,361.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,360.88 / $27,343.25 / $62,944.05
| Facility | | $22,360.88 | $27,343.25 | $62,944.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $21,507.31 / $48,544.80
| Facility | | $100.00 | $21,507.31 | $48,544.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,566.30 / $31,848.70 / $54,797.70
| Facility | | $21,566.30 | $31,848.70 | $54,797.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,900.80 / $43,417.60 / $50,954.24
| Facility | | $29,900.80 | $43,417.60 | $50,954.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,263.16 / $26,397.67 / $55,275.64
| Facility | | $19,263.16 | $26,397.67 | $55,275.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $24,186.02 / $49,515.35
| Facility | | $5,693.00 | $24,186.02 | $49,515.35 |