- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $27,138.00 / $42,782.80
| Facility | | $4,804.00 | $27,138.00 | $42,782.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,574.38 / $24,201.79 / $24,950.25
| Facility | | $23,574.38 | $24,201.79 | $24,950.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $26,573.51
| Facility | | $688.00 | $3,027.00 | $26,573.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,203.50 / $26,290.58 / $45,628.72
| Facility | | $16,203.50 | $26,290.58 | $45,628.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,797.90 / $58,595.51 / $58,595.51
| Facility | | $35,797.90 | $58,595.51 | $58,595.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,745.35 / $9,745.35 / $9,745.35
| Facility | | $9,745.35 | $9,745.35 | $9,745.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,600.00 / $23,590.00 / $45,628.72
| Facility | | $16,600.00 | $23,590.00 | $45,628.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $21,136.64 / $48,323.64
| Facility | | $5,257.00 | $21,136.64 | $48,323.64 |