- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $22,860.00 / $34,682.80
| Facility | | $4,804.00 | $22,860.00 | $34,682.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,302.22 / $20,302.22 / $21,704.43
| Facility | | $20,302.22 | $20,302.22 | $21,704.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $21,477.75
| Facility | | $675.00 | $2,690.00 | $21,477.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,715.00 / $20,314.00 / $39,538.74
| Facility | | $12,715.00 | $20,314.00 | $39,538.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,158.70 / $49,365.03 / $49,365.03
| Facility | | $30,158.70 | $49,365.03 | $49,365.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,457.00 / $18,533.21 / $44,108.55
| Facility | | $13,457.00 | $18,533.21 | $44,108.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,134.88 / $39,015.51
| Facility | | $5,257.00 | $17,134.88 | $39,015.51 |