- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,265.70 / $25,712.80 / $41,694.80
| Facility | | $16,265.70 | $25,712.80 | $41,694.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,458.20 / $18,933.39 / $43,266.31
| Facility | | $14,458.20 | $18,933.39 | $43,266.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,947.89 / $38,582.66
| Facility | | $100.00 | $17,947.89 | $38,582.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,728.66 / $29,486.11 / $53,742.00
| Facility | | $18,728.66 | $29,486.11 | $53,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,462.10 / $32,616.20 / $38,277.87
| Facility | | $22,462.10 | $32,616.20 | $38,277.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,828.30 / $22,829.15 / $55,697.04
| Facility | | $14,828.30 | $22,829.15 | $55,697.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $20,895.46 / $42,778.68
| Facility | | $5,693.00 | $20,895.46 | $42,778.68 |