- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,077.40 / $36,480.80 / $59,155.60
| Facility | | $23,077.40 | $36,480.80 | $59,155.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,291.10 / $29,190.78 / $66,706.33
| Facility | | $22,291.10 | $29,190.78 | $66,706.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $26,828.41 / $55,117.45
| Facility | | $100.00 | $26,828.41 | $55,117.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,011.44 / $40,677.46 / $67,754.16
| Facility | | $27,011.44 | $40,677.46 | $67,754.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,631.19 / $50,286.40 / $59,015.36
| Facility | | $34,631.19 | $50,286.40 | $59,015.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,315.80 / $32,356.96 / $67,754.16
| Facility | | $22,315.80 | $32,356.96 | $67,754.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $29,646.03 / $60,693.48
| Facility | | $5,693.00 | $29,646.03 | $60,693.48 |