- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,891.00 / $29,532.20
| Facility | | $4,804.00 | $18,891.00 | $29,532.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,061.83 / $16,061.83 / $19,290.99
| Facility | | $16,061.83 | $16,061.83 | $19,290.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $17,912.47
| Facility | | $675.00 | $2,690.00 | $17,912.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,072.95 / $17,586.45 / $33,666.98
| Facility | | $11,072.95 | $17,586.45 | $33,666.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,920.40 / $40,790.76 / $40,790.76
| Facility | | $24,920.40 | $40,790.76 | $40,790.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,459.00 / $16,101.37 / $37,558.14
| Facility | | $11,459.00 | $16,101.37 | $37,558.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,579.46 / $16,589.88 / $33,221.46
| Facility | | $5,579.46 | $16,589.88 | $33,221.46 |