- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,172.00 / $40,035.19
| Facility | | $4,804.00 | $25,172.00 | $40,035.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,519.13 / $21,172.56 / $32,015.41
| Facility | | $12,519.13 | $21,172.56 | $32,015.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $25,538.25
| Facility | | $687.00 | $2,767.00 | $25,538.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,443.67 / $26,490.00 / $49,416.21
| Facility | | $15,443.67 | $26,490.00 | $49,416.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,208.19 / $54,356.58 / $54,356.58
| Facility | | $33,208.19 | $54,356.58 | $54,356.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,258.40 / $37,542.33 / $69,112.72
| Facility | | $21,258.40 | $37,542.33 | $69,112.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,593.78 / $22,375.22 / $53,087.73
| Facility | | $15,593.78 | $22,375.22 | $53,087.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,081.00 / $22,852.04 / $48,423.72
| Facility | | $7,081.00 | $22,852.04 | $48,423.72 |