- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,080.00 / $38,248.40 / $46,184.00
| Facility | | $20,080.00 | $38,248.40 | $46,184.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $34,537.60 / $59,390.51
| Facility | | $12,397.00 | $34,537.60 | $59,390.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,861.60 / $31,858.88 / $35,103.44
| Facility | | $24,861.60 | $31,858.88 | $35,103.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,060.84 / $27,118.40 / $37,315.58
| Facility | | $17,060.84 | $27,118.40 | $37,315.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,174.94 / $34,897.10 / $54,757.00
| Facility | | $21,174.94 | $34,897.10 | $54,757.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,538.82 / $31,147.07 / $42,413.49
| Facility | | $23,538.82 | $31,147.07 | $42,413.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $33,745.64 / $48,553.44
| Facility | | $3,775.00 | $33,745.64 | $48,553.44 |