- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $27,542.29 / $51,286.14
| Facility | | $15,135.61 | $27,542.29 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $29,512.09 / $50,118.72
| Facility | | $10,232.93 | $29,512.09 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $26,915.35 / $41,686.94
| Facility | | $100.00 | $26,915.35 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $23,988.33 / $42,657.95
| Facility | | $16,218.10 | $23,988.33 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $42,657.95 / $42,657.95
| Facility | | $42,657.95 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $47,863.01
| Facility | | $16,595.87 | $26,915.35 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $22,908.68 / $46,773.51
| Facility | | $5,754.40 | $22,908.68 | $46,773.51 |