- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $26,915.35 / $51,286.14
| Facility | | $15,135.61 | $26,915.35 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $29,512.09 / $48,977.88
| Facility | | $16,595.87 | $29,512.09 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $20,417.38 / $44,668.36
| Facility | | $100.00 | $20,417.38 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $23,988.33 / $41,686.94
| Facility | | $16,982.44 | $23,988.33 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,686.94 / $41,686.94 / $41,686.94
| Facility | | $41,686.94 | $41,686.94 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $26,915.35 / $48,977.88
| Facility | | $16,595.87 | $26,915.35 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $22,908.68 / $46,773.51
| Facility | | $5,754.40 | $22,908.68 | $46,773.51 |