- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,455.20 / $22,850.80 / $37,053.80
| Facility | | $14,455.20 | $22,850.80 | $37,053.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,573.65 / $17,775.05 / $40,619.29
| Facility | | $13,573.65 | $17,775.05 | $40,619.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,759.88 / $34,764.82
| Facility | | $100.00 | $15,759.88 | $34,764.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,934.23 / $24,452.89 / $42,615.00
| Facility | | $15,934.23 | $24,452.89 | $42,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,087.88 / $30,620.75 / $35,936.05
| Facility | | $21,087.88 | $30,620.75 | $35,936.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,938.47 / $20,267.68 / $44,176.13
| Facility | | $13,938.47 | $20,267.68 | $44,176.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $18,569.61 / $38,017.04
| Facility | | $5,693.00 | $18,569.61 | $38,017.04 |