- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $40,738.03 / $63,095.73
| Facility | | $19,498.45 | $40,738.03 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $45,708.82 / $53,703.18
| Facility | | $20,892.96 | $45,708.82 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $36,307.81 / $57,543.99
| Facility | | $100.00 | $36,307.81 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $31,622.78 / $52,480.75
| Facility | | $20,417.38 | $31,622.78 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,480.75 / $52,480.75 / $52,480.75
| Facility | | $52,480.75 | $52,480.75 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $38,018.94 / $58,884.37
| Facility | | $20,892.96 | $38,018.94 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $29,512.09 / $57,543.99
| Facility | | $5,754.40 | $29,512.09 | $57,543.99 |