- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $33,884.42 / $70,794.58
| Facility | | $20,892.96 | $33,884.42 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $39,810.72 / $67,608.30
| Facility | | $10,232.93 | $39,810.72 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $24,547.09 / $54,954.09
| Facility | | $100.00 | $24,547.09 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $32,359.37 / $57,543.99
| Facility | | $21,877.62 | $32,359.37 | $57,543.99 |
- 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
- $21,877.62 / $32,359.37 / $64,565.42
| Facility | | $21,877.62 | $32,359.37 | $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 |