- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,980.00 / $29,797.40
| Facility | | $4,804.00 | $18,980.00 | $29,797.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,095.32 / $19,202.96 / $25,131.61
| Facility | | $11,095.32 | $19,202.96 | $25,131.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $19,249.07
| Facility | | $688.00 | $3,027.00 | $19,249.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,285.44 / $18,310.91 / $31,779.56
| Facility | | $11,285.44 | $18,310.91 | $31,779.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,036.30 / $40,980.47 / $40,980.47
| Facility | | $25,036.30 | $40,980.47 | $40,980.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,786.49 / $20,650.43 / $42,070.60
| Facility | | $8,786.49 | $20,650.43 | $42,070.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,606.15 / $16,430.00 / $31,779.56
| Facility | | $11,606.15 | $16,430.00 | $31,779.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,126.16 / $14,721.28 / $33,656.53
| Facility | | $5,126.16 | $14,721.28 | $33,656.53 |