- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $25,118.86 / $47,863.01
| Facility | | $14,125.38 | $25,118.86 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $15,848.93 / $17,378.01
| Facility | | $13,489.63 | $15,848.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $27,542.29 / $45,708.82
| Facility | | $15,488.17 | $27,542.29 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $24,547.09 / $38,904.51
| Facility | | $100.00 | $24,547.09 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $22,387.21 / $38,904.51
| Facility | | $14,791.08 | $22,387.21 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $25,118.86 / $44,668.36
| Facility | | $15,135.61 | $25,118.86 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $21,379.62 / $43,651.58
| Facility | | $5,754.40 | $21,379.62 | $43,651.58 |