- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.10 / $39,706.80 / $64,386.80
| Facility | | $25,118.10 | $39,706.80 | $64,386.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,738.75 / $29,390.75 / $67,163.32
| Facility | | $16,738.75 | $29,390.75 | $67,163.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $27,855.63 / $56,312.28
| Facility | | $100.00 | $27,855.63 | $56,312.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,432.57 / $43,345.12 / $73,745.67
| Facility | | $29,432.57 | $43,345.12 | $73,745.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,868.44 / $50,630.90 / $59,419.66
| Facility | | $34,868.44 | $50,630.90 | $59,419.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,467.34 / $35,414.18 / $73,745.67
| Facility | | $22,467.34 | $35,414.18 | $73,745.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $32,267.64 / $66,060.63
| Facility | | $5,693.00 | $32,267.64 | $66,060.63 |