- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $26,254.00 / $39,813.10
| Facility | | $4,804.00 | $26,254.00 | $39,813.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,673.00 / $25,791.74 / $30,611.81
| Facility | | $13,673.00 | $25,791.74 | $30,611.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $25,692.91
| Facility | | $688.00 | $3,027.00 | $25,692.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,927.70 / $23,708.70 / $42,461.40
| Facility | | $14,927.70 | $23,708.70 | $42,461.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,635.10 / $56,692.19 / $56,692.19
| Facility | | $34,635.10 | $56,692.19 | $56,692.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,974.01 / $28,915.95 / $69,709.89
| Facility | | $15,974.01 | $28,915.95 | $69,709.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,448.00 / $21,706.63 / $42,461.40
| Facility | | $15,448.00 | $21,706.63 | $42,461.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $19,669.43 / $44,969.26
| Facility | | $5,257.00 | $19,669.43 | $44,969.26 |