- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,188.20 / $27,077.00 / $44,763.80
| Facility | | $11,188.20 | $27,077.00 | $44,763.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,980.67 / $43,005.32 / $55,764.67
| Facility | | $28,980.67 | $43,005.32 | $55,764.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $35,923.51 / $57,437.91
| Facility | | $17,646.00 | $35,923.51 | $57,437.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,140.30 / $38,700.07 / $81,155.28
| Facility | | $20,140.30 | $38,700.07 | $81,155.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,886.37 / $13,886.37 / $13,886.37
| Facility | | $13,886.37 | $13,886.37 | $13,886.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $38,444.51 / $57,452.09
| Facility | | $17,648.00 | $38,444.51 | $57,452.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $25,723.36 / $49,412.36
| Facility | | $5,281.00 | $25,723.36 | $49,412.36 |