- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,552.80 / $28,013.30
| Facility | | $4,804.00 | $18,552.80 | $28,013.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,699.77 / $19,699.77 / $23,304.20
| Facility | | $19,699.77 | $19,699.77 | $23,304.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $18,927.89
| Facility | | $688.00 | $3,030.00 | $18,927.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,609.72 / $17,214.54 / $32,573.05
| Facility | | $10,609.72 | $17,214.54 | $32,573.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,087.00 / $42,700.30 / $42,700.30
| Facility | | $26,087.00 | $42,700.30 | $42,700.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,056.14 / $69,056.14 / $69,056.14
| Facility | | $69,056.14 | $69,056.14 | $69,056.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,869.00 / $15,446.25 / $35,626.47
| Facility | | $10,869.00 | $15,446.25 | $35,626.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,819.22 / $13,839.84 / $31,641.33
| Facility | | $4,819.22 | $13,839.84 | $31,641.33 |