- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,063.00 / $27,256.10
| Facility | | $4,804.00 | $17,063.00 | $27,256.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,698.58 / $23,698.58 / $23,698.58
| Facility | | $23,698.58 | $23,698.58 | $23,698.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.00 / $2,753.00 / $18,402.04
| Facility | | $826.00 | $2,753.00 | $18,402.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,322.95 / $16,777.00 / $31,692.63
| Facility | | $10,322.95 | $16,777.00 | $31,692.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,511.20 / $36,847.28 / $36,847.28
| Facility | | $22,511.20 | $36,847.28 | $36,847.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,406.70 / $16,406.70 / $16,406.70
| Facility | | $16,406.70 | $16,406.70 | $16,406.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,616.31 / $15,028.75 / $34,663.51
| Facility | | $10,616.31 | $15,028.75 | $34,663.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,688.97 / $13,465.76 / $30,786.09
| Facility | | $4,688.97 | $13,465.76 | $30,786.09 |