- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,530.00 / $15,924.00 / $38,885.50
| Facility | | $7,530.00 | $15,924.00 | $38,885.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,993.74 / $28,220.44 / $59,985.07
| Facility | | $22,993.74 | $28,220.44 | $59,985.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $23,019.37 / $45,951.34
| Facility | | $100.00 | $23,019.37 | $45,951.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,827.23 / $33,094.58 / $58,804.29
| Facility | | $21,827.23 | $33,094.58 | $58,804.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,141.80 / $45,219.60 / $53,069.04
| Facility | | $31,141.80 | $45,219.60 | $53,069.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,121.83 / $28,327.77 / $59,317.18
| Facility | | $20,121.83 | $28,327.77 | $59,317.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $27,412.62 / $53,135.72
| Facility | | $5,717.00 | $27,412.62 | $53,135.72 |