- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,591.00 / $34,614.80
| Facility | | $4,804.00 | $21,591.00 | $34,614.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,030.27 / $24,347.44 / $27,312.12
| Facility | | $21,030.27 | $24,347.44 | $27,312.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $21,322.22
| Facility | | $687.00 | $2,767.00 | $21,322.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,352.74 / $22,860.75 / $41,543.90
| Facility | | $13,352.74 | $22,860.75 | $41,543.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,482.90 / $46,622.01 / $46,622.01
| Facility | | $28,482.90 | $46,622.01 | $46,622.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,793.35 / $30,084.81 / $376,754.31
| Facility | | $15,793.35 | $30,084.81 | $376,754.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,431.00 / $19,345.82 / $45,439.02
| Facility | | $13,431.00 | $19,345.82 | $45,439.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,101.28 / $39,097.80
| Facility | | $5,257.00 | $17,101.28 | $39,097.80 |