- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $28,593.00 / $43,907.30
| Facility | | $4,804.00 | $28,593.00 | $43,907.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,229.01 / $26,247.58 / $36,048.14
| Facility | | $16,229.01 | $26,247.58 | $36,048.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $28,342.43
| Facility | | $688.00 | $3,027.00 | $28,342.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,462.80 / $26,146.80 / $46,827.95
| Facility | | $16,462.80 | $26,146.80 | $46,827.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,720.69 / $61,742.83 / $61,742.83
| Facility | | $37,720.69 | $61,742.83 | $61,742.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,955.23 / $72,248.64 / $652,595.15
| Facility | | $31,955.23 | $72,248.64 | $652,595.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,036.00 / $23,938.85 / $46,827.95
| Facility | | $17,036.00 | $23,938.85 | $46,827.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $21,692.16 / $49,593.70
| Facility | | $5,257.00 | $21,692.16 | $49,593.70 |