- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $36,307.81 / $67,608.30
| Facility | | $20,417.38 | $36,307.81 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $39,810.72 / $57,543.99
| Facility | | $22,387.21 | $39,810.72 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $33,884.42 / $53,703.18
| Facility | | $100.00 | $33,884.42 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $34,673.69 / $56,234.13
| Facility | | $22,387.21 | $34,673.69 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $56,234.13 / $56,234.13
| Facility | | $56,234.13 | $56,234.13 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $38,018.94 / $63,095.73
| Facility | | $22,908.68 | $38,018.94 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $31,622.78 / $61,659.50
| Facility | | $5,754.40 | $31,622.78 | $61,659.50 |