- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $15,308.30 / $23,114.30
| Facility | | $4,804.00 | $15,308.30 | $23,114.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,755.18 / $18,755.18 / $19,459.97
| Facility | | $18,755.18 | $18,755.18 | $19,459.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $15,730.04
| Facility | | $687.00 | $2,767.00 | $15,730.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,916.40 / $15,294.00 / $27,741.28
| Facility | | $8,916.40 | $15,294.00 | $27,741.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,729.00 / $33,930.10 / $33,930.10
| Facility | | $20,729.00 | $33,930.10 | $33,930.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,943.09 / $23,943.09 / $29,454.90
| Facility | | $23,943.09 | $23,943.09 | $29,454.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,003.07 / $12,918.33 / $30,342.28
| Facility | | $9,003.07 | $12,918.33 | $30,342.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,205.85 / $11,419.52 / $26,107.88
| Facility | | $4,205.85 | $11,419.52 | $26,107.88 |