- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,669.60 / $55,317.80 / $77,774.00
| Facility | | $27,669.60 | $55,317.80 | $77,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,942.91 / $42,956.49 / $69,098.00
| Facility | | $27,942.91 | $42,956.49 | $69,098.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $26,219.78 / $59,351.98
| Facility | | $100.00 | $26,219.78 | $59,351.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,929.42 / $52,952.36 / $70,182.85
| Facility | | $28,929.42 | $52,952.36 | $70,182.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,365.05 / $54,256.10 / $63,674.14
| Facility | | $37,365.05 | $54,256.10 | $63,674.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,036.76 / $40,561.98 / $70,465.00
| Facility | | $24,036.76 | $40,561.98 | $70,465.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,212.00 / $46,212.00 / $46,212.00
| Facility | | $46,212.00 | $46,212.00 | $46,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $28,565.50 / $65,357.71
| Facility | | $5,693.00 | $28,565.50 | $65,357.71 |