- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $26,316.00 / $40,883.10
| Facility | | $4,804.00 | $26,316.00 | $40,883.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,360.73 / $25,360.73 / $28,062.47
| Facility | | $25,360.73 | $25,360.73 | $28,062.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $27,634.36
| Facility | | $688.00 | $3,030.00 | $27,634.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,483.99 / $25,428.00 / $49,066.91
| Facility | | $15,483.99 | $25,428.00 | $49,066.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,716.80 / $56,825.92 / $56,825.92
| Facility | | $34,716.80 | $56,825.92 | $56,825.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,924.02 / $22,542.50 / $51,993.83
| Facility | | $15,924.02 | $22,542.50 | $51,993.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $20,198.08 / $46,177.86
| Facility | | $5,257.00 | $20,198.08 | $46,177.86 |