- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,199.52 / $60,255.96
| Facility | | $19,054.61 | $30,199.52 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $30,902.95 / $51,286.14
| Facility | | $18,197.01 | $30,902.95 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $25,703.96 / $48,977.88
| Facility | | $100.00 | $25,703.96 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $27,542.29 / $46,773.51
| Facility | | $20,417.38 | $27,542.29 | $46,773.51 |
- 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 / $28,183.83 / $51,286.14
| Facility | | $20,892.96 | $28,183.83 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $18,197.01
| Facility | | $18,197.01 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $26,915.35 / $56,234.13
| Facility | | $5,888.44 | $26,915.35 | $56,234.13 |