- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $26,302.68 / $42,657.95
| Facility | | $18,620.87 | $26,302.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $29,512.09 / $33,884.42
| Facility | | $25,118.86 | $29,512.09 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $18,620.87 / $31,622.78
| Facility | | $9,120.11 | $18,620.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $50,118.72
| Facility | | $16,595.87 | $26,915.35 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,069.34 / $66,069.34 / $66,069.34
| Facility | | $66,069.34 | $66,069.34 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $25,703.96 / $42,657.95
| Facility | | $10,000.00 | $25,703.96 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,908.68 / $54,954.09
| Facility | | $16,218.10 | $22,908.68 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $22,387.21 / $50,118.72
| Facility | | $7,079.46 | $22,387.21 | $50,118.72 |