- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $23,988.33 / $44,668.36
| Facility | | $13,182.57 | $23,988.33 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $16,982.44 / $16,982.44
| Facility | | $16,982.44 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $25,703.96 / $43,651.58
| Facility | | $14,791.08 | $25,703.96 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $27,542.29 / $57,543.99
| Facility | | $100.00 | $27,542.29 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $20,892.96 / $37,153.52
| Facility | | $14,454.40 | $20,892.96 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,153.52 / $37,153.52 / $37,153.52
| Facility | | $37,153.52 | $37,153.52 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $23,442.29 / $43,651.58
| Facility | | $14,454.40 | $23,442.29 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $19,952.62 / $40,738.03
| Facility | | $5,754.40 | $19,952.62 | $40,738.03 |