- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,343.00 / $26,800.50
| Facility | | $4,804.00 | $16,343.00 | $26,800.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,422.68 / $16,540.00 / $22,758.63
| Facility | | $16,422.68 | $16,540.00 | $22,758.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $16,638.45
| Facility | | $688.00 | $3,027.00 | $16,638.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,150.37 / $16,469.23 / $28,583.23
| Facility | | $10,150.37 | $16,469.23 | $28,583.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,561.20 / $35,292.28 / $35,292.28
| Facility | | $21,561.20 | $35,292.28 | $35,292.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,733.00 / $5,733.00 / $5,733.00
| Facility | | $5,733.00 | $5,733.00 | $5,733.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,399.00 / $14,777.50 / $28,583.23
| Facility | | $10,399.00 | $14,777.50 | $28,583.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,610.58 / $13,240.64 / $30,271.41
| Facility | | $4,610.58 | $13,240.64 | $30,271.41 |