- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,094.40 / $23,895.00 / $30,177.10
| Facility | | $15,094.40 | $23,895.00 | $30,177.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,048.28 / $20,281.22 / $31,914.75
| Facility | | $15,048.28 | $20,281.22 | $31,914.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,846.18 / $28,868.87
| Facility | | $100.00 | $14,846.18 | $28,868.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,258.11 / $24,958.07 / $40,971.10
| Facility | | $16,258.11 | $24,958.07 | $40,971.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,290.86 / $34,290.86 / $34,290.86
| Facility | | $34,290.86 | $34,290.86 | $34,290.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,313.33 / $22,127.47 / $41,328.44
| Facility | | $13,313.33 | $22,127.47 | $41,328.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,367.00 / $16,367.00 / $16,367.00
| Facility | | $16,367.00 | $16,367.00 | $16,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $18,083.38 / $37,021.60
| Facility | | $5,693.00 | $18,083.38 | $37,021.60 |