- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,322.00 / $14,554.10
| Facility | | $4,804.00 | $9,322.00 | $14,554.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,547.13 / $10,547.13 / $15,023.33
| Facility | | $10,547.13 | $10,547.13 | $15,023.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $9,785.41
| Facility | | $688.00 | $2,753.00 | $9,785.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,512.21 / $9,052.00 / $16,923.12
| Facility | | $5,512.21 | $9,052.00 | $16,923.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,296.80 / $20,127.91 / $20,127.91
| Facility | | $12,296.80 | $20,127.91 | $20,127.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $276,413.55 / $276,413.55 / $276,413.55
| Facility | | $276,413.55 | $276,413.55 | $276,413.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,668.86 / $8,025.00 / $18,509.50
| Facility | | $5,668.86 | $8,025.00 | $18,509.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,081.60 / $7,190.40 / $16,439.05
| Facility | | $3,081.60 | $7,190.40 | $16,439.05 |