- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,773.40 / $40,720.60 / $52,870.00
| Facility | | $19,773.40 | $40,720.60 | $52,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,070.57 / $32,503.01 / $56,557.40
| Facility | | $23,070.57 | $32,503.01 | $56,557.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $20,865.09 / $47,428.91
| Facility | | $100.00 | $20,865.09 | $47,428.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,502.06 / $40,747.94 / $53,206.22
| Facility | | $22,502.06 | $40,747.94 | $53,206.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,849.80 / $44,795.60 / $52,571.44
| Facility | | $30,849.80 | $44,795.60 | $52,571.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,938.16 / $30,438.07 / $56,850.50
| Facility | | $19,938.16 | $30,438.07 | $56,850.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $24,875.10 / $50,926.09
| Facility | | $5,693.00 | $24,875.10 | $50,926.09 |