- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,365.00 / $44,505.70 / $53,739.50
| Facility | | $23,365.00 | $44,505.70 | $53,739.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $40,187.80 / $64,443.60
| Facility | | $12,397.00 | $40,187.80 | $64,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,693.80 / $35,784.44 / $42,389.08
| Facility | | $28,693.80 | $35,784.44 | $42,389.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,755.56 / $29,533.41 / $39,050.00
| Facility | | $19,755.56 | $29,533.41 | $39,050.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,986.44 / $37,270.80 / $57,503.52
| Facility | | $21,986.44 | $37,270.80 | $57,503.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,438.38 / $33,402.11 / $43,956.47
| Facility | | $24,438.38 | $33,402.11 | $43,956.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $39,266.28 / $56,496.57
| Facility | | $3,775.00 | $39,266.28 | $56,496.57 |