- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,824.00 / $28,006.50
| Facility | | $4,804.00 | $17,824.00 | $28,006.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,900.88 / $18,439.55 / $24,243.51
| Facility | | $14,900.88 | $18,439.55 | $24,243.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $17,908.41
| Facility | | $688.00 | $3,027.00 | $17,908.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,607.14 / $17,419.00 / $31,927.68
| Facility | | $10,607.14 | $17,419.00 | $31,927.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,510.60 / $38,483.14 / $38,483.14
| Facility | | $23,510.60 | $38,483.14 | $38,483.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,096.89 / $33,996.00 / $124,145.50
| Facility | | $10,096.89 | $33,996.00 | $124,145.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,908.58 / $15,442.50 / $32,431.00
| Facility | | $10,908.58 | $15,442.50 | $32,431.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,818.06 / $13,836.48 / $31,633.65
| Facility | | $4,818.06 | $13,836.48 | $31,633.65 |