- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $19,224.00 / $29,371.30
| Facility | | $4,804.00 | $19,224.00 | $29,371.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,187.00 / $18,378.09 / $23,345.19
| Facility | | $11,187.00 | $18,378.09 | $23,345.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $19,239.38
| Facility | | $688.00 | $3,027.00 | $19,239.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,124.02 / $17,546.31 / $31,325.02
| Facility | | $11,124.02 | $17,546.31 | $31,325.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,353.60 / $41,499.83 / $41,499.83
| Facility | | $25,353.60 | $41,499.83 | $41,499.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,956.41 / $13,447.52 / $31,611.55
| Facility | | $7,956.41 | $13,447.52 | $31,611.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,396.00 / $16,195.00 / $31,325.02
| Facility | | $11,396.00 | $16,195.00 | $31,325.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.84 / $14,510.72 / $33,175.12
| Facility | | $5,052.84 | $14,510.72 | $33,175.12 |