- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $34,673.69 / $66,069.34
| Facility | | $19,498.45 | $34,673.69 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $37,153.52 / $63,095.73
| Facility | | $10,232.93 | $37,153.52 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $29,512.09 / $53,703.18
| Facility | | $100.00 | $29,512.09 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,902.95 / $53,703.18
| Facility | | $21,877.62 | $30,902.95 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $53,703.18 / $53,703.18
| Facility | | $53,703.18 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $33,884.42 / $63,095.73
| Facility | | $21,379.62 | $33,884.42 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $29,512.09 / $58,884.37
| Facility | | $5,754.40 | $29,512.09 | $58,884.37 |