- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,404.00 / $19,629.40 / $32,004.60
| Facility | | $4,404.00 | $19,629.40 | $32,004.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $22,615.28
| Facility | | $688.00 | $3,030.00 | $22,615.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,351.00 / $18,748.93 / $37,666.76
| Facility | | $10,351.00 | $18,748.93 | $37,666.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,537.00 / $48,537.00 / $48,537.00
| Facility | | $48,537.00 | $48,537.00 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,767.40 / $17,111.18 / $40,524.16
| Facility | | $11,767.40 | $17,111.18 | $40,524.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $15,505.28 / $35,448.94
| Facility | | $5,257.00 | $15,505.28 | $35,448.94 |