- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $38,934.00 / $62,503.50
| Facility | | $4,804.00 | $38,934.00 | $62,503.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,750.43 / $29,186.42 / $37,045.04
| Facility | | $18,750.43 | $29,186.42 | $37,045.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,914.00 / $40,955.62
| Facility | | $688.00 | $2,914.00 | $40,955.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,672.46 / $38,409.16 / $66,661.16
| Facility | | $23,672.46 | $38,409.16 | $66,661.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,364.60 / $84,075.74 / $84,075.74
| Facility | | $51,364.60 | $84,075.74 | $84,075.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,959.03 / $24,959.03 / $95,395.40
| Facility | | $24,959.03 | $24,959.03 | $95,395.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,345.19 / $34,463.75 / $66,661.16
| Facility | | $24,345.19 | $34,463.75 | $66,661.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,081.00 / $30,879.52 / $70,311.56
| Facility | | $7,081.00 | $30,879.52 | $70,311.56 |