- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,300.00 / $39,284.80
| Facility | | $4,804.00 | $25,300.00 | $39,284.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,999.86 / $23,999.86 / $23,999.86
| Facility | | $23,999.86 | $23,999.86 | $23,999.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.00 / $2,753.00 / $27,150.36
| Facility | | $826.00 | $2,753.00 | $27,150.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,417.73 / $24,141.03 / $45,679.24
| Facility | | $14,417.73 | $24,141.03 | $45,679.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,377.30 / $54,633.37 / $54,633.37
| Facility | | $33,377.30 | $54,633.37 | $54,633.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,243.00 / $21,661.25 / $49,961.24
| Facility | | $15,243.00 | $21,661.25 | $49,961.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $19,408.48 / $44,372.64
| Facility | | $5,257.00 | $19,408.48 | $44,372.64 |