- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,802.00 / $28,393.80 / $50,001.60
| Facility | | $17,802.00 | $28,393.80 | $50,001.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,404.16 / $23,906.53 / $34,753.24
| Facility | | $9,404.16 | $23,906.53 | $34,753.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,460.87 / $22,077.74 / $36,985.37
| Facility | | $16,460.87 | $22,077.74 | $36,985.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,466.73 / $18,774.80 / $24,159.17
| Facility | | $13,466.73 | $18,774.80 | $24,159.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $21,281.77 / $32,524.18
| Facility | | $6,600.00 | $21,281.77 | $32,524.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,434.16 / $23,019.92 / $31,296.83
| Facility | | $16,434.16 | $23,019.92 | $31,296.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,784.84 / $48,593.95
| Facility | | $3,775.00 | $17,784.84 | $48,593.95 |