- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,643.00 / $26,309.20 / $42,661.90
| Facility | | $16,643.00 | $26,309.20 | $42,661.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,253.80 / $21,098.23 / $48,568.03
| Facility | | $17,253.80 | $21,098.23 | $48,568.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,927.49 / $37,032.03
| Facility | | $100.00 | $17,927.49 | $37,032.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,214.08 / $27,429.21 / $48,440.48
| Facility | | $18,214.08 | $27,429.21 | $48,440.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,071.65 / $33,501.30 / $39,316.62
| Facility | | $23,071.65 | $33,501.30 | $39,316.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,046.22 / $23,191.62 / $48,862.97
| Facility | | $15,046.22 | $23,191.62 | $48,862.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $21,380.14 / $43,770.95
| Facility | | $5,693.00 | $21,380.14 | $43,770.95 |