- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $60,255.96 / $114,815.36
| Facility | | $28,183.83 | $60,255.96 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $66,069.34 / $134,896.29
| Facility | | $20,417.38 | $66,069.34 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $57,543.99 / $104,712.85
| Facility | | $100.00 | $57,543.99 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $63,095.73 / $117,489.76
| Facility | | $26,915.35 | $63,095.73 | $117,489.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134,896.29 / $134,896.29 / $134,896.29
| Facility | | $134,896.29 | $134,896.29 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $70,794.58 / $134,896.29
| Facility | | $30,902.95 | $70,794.58 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $39,810.72 / $39,810.72
| Facility | | $39,810.72 | $39,810.72 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $45,708.82 / $117,489.76
| Facility | | $7,943.28 | $45,708.82 | $117,489.76 |