- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,973.00 / $22,088.60 / $35,817.80
| Facility | | $13,973.00 | $22,088.60 | $35,817.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,578.62 / $21,495.43 / $49,482.38
| Facility | | $17,578.62 | $21,495.43 | $49,482.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $19,075.97 / $36,787.49
| Facility | | $100.00 | $19,075.97 | $36,787.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,828.11 / $26,008.97 / $42,702.61
| Facility | | $16,828.11 | $26,008.97 | $42,702.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,506.00 / $34,132.00 / $40,056.80
| Facility | | $23,506.00 | $34,132.00 | $40,056.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,505.45 / $20,109.80 / $42,702.61
| Facility | | $15,505.45 | $20,109.80 | $42,702.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,846.00 / $14,161.95 / $35,391.54
| Facility | | $4,846.00 | $14,161.95 | $35,391.54 |