- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,603.00 / $18,491.00 / $40,391.10
| Facility | | $3,603.00 | $18,491.00 | $40,391.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $26,457.66
| Facility | | $688.00 | $3,030.00 | $26,457.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,035.30 / $26,588.31 / $50,459.53
| Facility | | $16,035.30 | $26,588.31 | $50,459.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,926.55 / $46,359.10 / $54,406.34
| Facility | | $31,926.55 | $46,359.10 | $54,406.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,935.75 / $30,935.75 / $30,935.75
| Facility | | $30,935.75 | $30,935.75 | $30,935.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,901.67 / $24,052.95 / $53,021.61
| Facility | | $15,901.67 | $24,052.95 | $53,021.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,303.00 / $23,055.20 / $41,674.00
| Facility | | $8,303.00 | $23,055.20 | $41,674.00 |