- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,578.80 / $32,935.80 / $54,434.70
| Facility | | $20,578.80 | $32,935.80 | $54,434.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,868.00 / $25,340.41 / $57,907.53
| Facility | | $16,868.00 | $25,340.41 | $57,907.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $23,012.33 / $46,275.60
| Facility | | $100.00 | $23,012.33 | $46,275.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,009.14 / $35,669.98 / $61,372.44
| Facility | | $24,009.14 | $35,669.98 | $61,372.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,063.23 / $43,653.45 / $51,231.03
| Facility | | $30,063.23 | $43,653.45 | $51,231.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,576.68 / $29,729.35 / $61,907.73
| Facility | | $19,576.68 | $29,729.35 | $61,907.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,760.00 / $27,087.91 / $53,407.88
| Facility | | $5,760.00 | $27,087.91 | $53,407.88 |