- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $23,422.00 / $35,444.50
| Facility | | $4,804.00 | $23,422.00 | $35,444.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $22,898.18
| Facility | | $688.00 | $3,027.00 | $22,898.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,424.21 / $21,781.12 / $37,802.30
| Facility | | $13,424.21 | $21,781.12 | $37,802.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,899.70 / $50,577.93 / $50,577.93
| Facility | | $30,899.70 | $50,577.93 | $50,577.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,331.85 / $44,331.85 / $44,331.85
| Facility | | $44,331.85 | $44,331.85 | $44,331.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,753.00 / $19,543.75 / $37,802.30
| Facility | | $13,753.00 | $19,543.75 | $37,802.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,511.20 / $40,034.98
| Facility | | $5,257.00 | $17,511.20 | $40,034.98 |