- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,840.59 / $31,030.00 / $39,665.90
| Facility | | $19,840.59 | $31,030.00 | $39,665.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,230.00 / $28,236.62 / $44,433.46
| Facility | | $19,230.00 | $28,236.62 | $44,433.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $21,477.22 / $42,047.50
| Facility | | $100.00 | $21,477.22 | $42,047.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,598.35 / $32,095.00 / $53,608.35
| Facility | | $22,598.35 | $32,095.00 | $53,608.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,015.57 / $40,680.15 / $47,741.61
| Facility | | $28,015.57 | $40,680.15 | $47,741.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,424.38 / $29,085.18 / $54,323.65
| Facility | | $18,424.38 | $29,085.18 | $54,323.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $20,483.04 / $46,865.09
| Facility | | $5,693.00 | $20,483.04 | $46,865.09 |