- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $28,183.83 / $52,480.75
| Facility | | $14,125.38 | $28,183.83 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $19,054.61 / $25,118.86
| Facility | | $17,378.01 | $19,054.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $30,199.52 / $50,118.72
| Facility | | $17,378.01 | $30,199.52 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $30,902.95 / $64,565.42
| Facility | | $100.00 | $30,902.95 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $24,547.09 / $45,708.82
| Facility | | $16,595.87 | $24,547.09 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $43,651.58 / $43,651.58
| Facility | | $43,651.58 | $43,651.58 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $27,542.29 / $48,977.88
| Facility | | $16,595.87 | $27,542.29 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $23,442.29 / $47,863.01
| Facility | | $5,754.40 | $23,442.29 | $47,863.01 |