- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,813.60 / $40,806.30 / $66,169.60
| Facility | | $25,813.60 | $40,806.30 | $66,169.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,595.53 / $33,518.01 / $76,594.87
| Facility | | $25,595.53 | $33,518.01 | $76,594.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $29,245.76 / $58,820.19
| Facility | | $100.00 | $29,245.76 | $58,820.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,022.94 / $43,667.33 / $75,787.69
| Facility | | $28,022.94 | $43,667.33 | $75,787.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,764.93 / $57,740.85 / $67,763.78
| Facility | | $39,764.93 | $57,740.85 | $67,763.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,547.62 / $36,229.90 / $75,787.69
| Facility | | $25,547.62 | $36,229.90 | $75,787.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $33,161.12 / $67,889.83
| Facility | | $5,693.00 | $33,161.12 | $67,889.83 |