- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,313.00 / $39,167.00
| Facility | | $4,804.00 | $25,313.00 | $39,167.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,021.63 / $19,021.63 / $21,430.09
| Facility | | $19,021.63 | $19,021.63 | $21,430.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,899.00 / $28,182.03
| Facility | | $687.00 | $2,899.00 | $28,182.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,549.30 / $27,715.76 / $51,414.62
| Facility | | $15,549.30 | $27,715.76 | $51,414.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,394.40 / $54,661.36 / $54,661.36
| Facility | | $33,394.40 | $54,661.36 | $54,661.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,547.57 / $22,555.12 / $51,414.62
| Facility | | $15,547.57 | $22,555.12 | $51,414.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,126.76 / $21,342.28 / $47,243.96
| Facility | | $7,126.76 | $21,342.28 | $47,243.96 |