- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $23,442.29 / $43,651.58
| Facility | | $12,882.50 | $23,442.29 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $12,882.50 / $19,952.62
| Facility | | $2,691.53 | $12,882.50 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $25,118.86 / $42,657.95
| Facility | | $14,454.40 | $25,118.86 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $16,218.10 / $36,307.81
| Facility | | $100.00 | $16,218.10 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $20,417.38 / $35,481.34
| Facility | | $13,803.84 | $20,417.38 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $36,307.81
| Facility | | $36,307.81 | $36,307.81 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $22,908.68 / $41,686.94
| Facility | | $13,803.84 | $22,908.68 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $19,498.45 / $39,810.72
| Facility | | $5,754.40 | $19,498.45 | $39,810.72 |