- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,242.00 / $16,392.70
| Facility | | $4,804.00 | $10,242.00 | $16,392.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,345.32 / $12,494.66 / $13,595.38
| Facility | | $10,345.32 | $12,494.66 | $13,595.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,683.51
| Facility | | $688.00 | $2,753.00 | $10,683.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,507.90 / $11,064.88 / $19,060.91
| Facility | | $6,507.90 | $11,064.88 | $19,060.91 |
- 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
- $41,779.91 / $41,779.91 / $41,990.23
| Facility | | $41,779.91 | $41,779.91 | $41,990.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,507.18 / $9,440.07 / $20,847.70
| Facility | | $6,507.18 | $9,440.07 | $20,847.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,832.43 / $10,216.68 / $21,889.00
| Facility | | $3,832.43 | $10,216.68 | $21,889.00 |