- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $33,416.00 / $51,814.60
| Facility | | $4,804.00 | $33,416.00 | $51,814.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,535.41 / $32,314.07 / $44,576.40
| Facility | | $28,535.41 | $32,314.07 | $44,576.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $31,687.02
| Facility | | $675.00 | $2,690.00 | $31,687.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,427.59 / $30,348.20 / $59,069.05
| Facility | | $19,427.59 | $30,348.20 | $59,069.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,083.80 / $72,158.22 / $72,158.22
| Facility | | $44,083.80 | $72,158.22 | $72,158.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,104.00 / $27,687.76 / $65,896.13
| Facility | | $20,104.00 | $27,687.76 | $65,896.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,428.10 / $28,234.02 / $57,843.96
| Facility | | $9,428.10 | $28,234.02 | $57,843.96 |