- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,099.30 / $25,449.90 / $41,268.40
| Facility | | $16,099.30 | $25,449.90 | $41,268.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,686.10 / $8,686.10 / $8,686.10
| Facility | | $8,686.10 | $8,686.10 | $8,686.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,124.54 / $22,162.99 / $51,019.10
| Facility | | $18,124.54 | $22,162.99 | $51,019.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,606.58 / $56,458.00
| Facility | | $100.00 | $17,606.58 | $56,458.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,674.61 / $26,371.42 / $46,858.19
| Facility | | $16,674.61 | $26,371.42 | $46,858.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,236.00 / $35,192.00 / $41,300.80
| Facility | | $24,236.00 | $35,192.00 | $41,300.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,779.83 / $22,572.98 / $47,266.88
| Facility | | $15,779.83 | $22,572.98 | $47,266.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $20,681.77 / $42,341.19
| Facility | | $5,693.00 | $20,681.77 | $42,341.19 |