- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $25,703.96 / $52,480.75
| Facility | | $16,595.87 | $25,703.96 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $19,498.45 / $32,359.37
| Facility | | $17,782.79 | $19,498.45 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $27,542.29 / $44,668.36
| Facility | | $17,782.79 | $27,542.29 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $22,908.68 / $42,657.95
| Facility | | $100.00 | $22,908.68 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $24,547.09 / $40,738.03
| Facility | | $17,782.79 | $24,547.09 | $40,738.03 |
- 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
- $18,197.01 / $25,118.86 / $44,668.36
| Facility | | $18,197.01 | $25,118.86 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $16,218.10 / $16,218.10
| Facility | | $16,218.10 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $23,988.33 / $47,863.01
| Facility | | $5,888.44 | $23,988.33 | $47,863.01 |