- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $31,622.78 / $58,884.37
| Facility | | $17,378.01 | $31,622.78 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $33,884.42 / $57,543.99
| Facility | | $10,232.93 | $33,884.42 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $28,840.32 / $51,286.14
| Facility | | $100.00 | $28,840.32 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $27,542.29 / $48,977.88
| Facility | | $19,054.61 | $27,542.29 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $30,902.95 / $56,234.13
| Facility | | $19,054.61 | $30,902.95 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $26,302.68 / $53,703.18
| Facility | | $5,754.40 | $26,302.68 | $53,703.18 |