- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $46,773.51 / $77,624.71
| Facility | | $23,988.33 | $46,773.51 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $50,118.72 / $67,608.30
| Facility | | $25,703.96 | $50,118.72 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $41,686.94 / $64,565.42
| Facility | | $100.00 | $41,686.94 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $37,153.52 / $64,565.42
| Facility | | $26,915.35 | $37,153.52 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,565.42 / $64,565.42 / $64,565.42
| Facility | | $64,565.42 | $64,565.42 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $46,773.51 / $72,443.60
| Facility | | $26,915.35 | $46,773.51 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $30,902.95 / $30,902.95
| Facility | | $30,902.95 | $30,902.95 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $36,307.81 / $70,794.58
| Facility | | $5,754.40 | $36,307.81 | $70,794.58 |