- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,833.70 / $36,097.00 / $49,293.60
| Facility | | $20,833.70 | $36,097.00 | $49,293.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,833.21 / $22,833.21 / $22,833.21
| Facility | | $22,833.21 | $22,833.21 | $22,833.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,095.00 / $37,835.61 / $55,507.00
| Facility | | $18,095.00 | $37,835.61 | $55,507.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,864.47 / $31,814.00 / $48,279.52
| Facility | | $16,864.47 | $31,814.00 | $48,279.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,381.78 / $36,381.78 / $44,177.87
| Facility | | $36,381.78 | $36,381.78 | $44,177.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,173.05 / $40,100.29 / $69,986.77
| Facility | | $27,173.05 | $40,100.29 | $69,986.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,910.80 / $35,326.40 / $49,293.60
| Facility | | $19,910.80 | $35,326.40 | $49,293.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,864.47 / $29,806.65 / $46,542.53
| Facility | | $16,864.47 | $29,806.65 | $46,542.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $17,726.59 / $25,456.60
| Facility | | $2,621.40 | $17,726.59 | $25,456.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,268.94 / $27,830.58 / $50,481.43
| Facility | | $10,268.94 | $27,830.58 | $50,481.43 |