- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,047.20 / $28,529.10 / $46,261.60
| Facility | | $18,047.20 | $28,529.10 | $46,261.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,095.91 / $25,006.60 / $57,144.71
| Facility | | $19,095.91 | $25,006.60 | $57,144.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $22,782.00 / $43,799.84
| Facility | | $100.00 | $22,782.00 | $43,799.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,380.02 / $33,157.85 / $55,153.85
| Facility | | $21,380.02 | $33,157.85 | $55,153.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,667.20 / $43,078.40 / $50,556.16
| Facility | | $29,667.20 | $43,078.40 | $50,556.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,331.20 / $25,329.63 / $55,153.85
| Facility | | $19,331.20 | $25,329.63 | $55,153.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $23,184.14 / $47,464.23
| Facility | | $5,693.00 | $23,184.14 | $47,464.23 |