- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,494.90 / $22,913.60 / $37,155.69
| Facility | | $14,494.90 | $22,913.60 | $37,155.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,497.28 / $16,497.28 / $16,497.28
| Facility | | $16,497.28 | $16,497.28 | $16,497.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,708.84 / $19,209.03 / $44,219.11
| Facility | | $15,708.84 | $19,209.03 | $44,219.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $16,287.51 / $32,973.17
| Facility | | $100.00 | $16,287.51 | $32,973.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,863.89 / $23,505.27 / $42,188.51
| Facility | | $14,863.89 | $23,505.27 | $42,188.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,005.75 / $30,501.50 / $35,796.10
| Facility | | $21,005.75 | $30,501.50 | $35,796.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,745.46 / $20,343.90 / $42,556.48
| Facility | | $13,745.46 | $20,343.90 | $42,556.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,620.00 / $11,032.94 / $36,713.53
| Facility | | $4,620.00 | $11,032.94 | $36,713.53 |