- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,549.59 / $29,103.70
| Facility | | $4,804.00 | $18,549.59 | $29,103.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,911.00 / $18,706.08 / $24,977.19
| Facility | | $12,911.00 | $18,706.08 | $24,977.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $18,958.99
| Facility | | $688.00 | $3,027.00 | $18,958.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,599.00 / $17,131.03 / $30,508.22
| Facility | | $9,599.00 | $17,131.03 | $30,508.22 |
- 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
- $1,980.00 / $18,952.78 / $72,012.47
| Facility | | $1,980.00 | $18,952.78 | $72,012.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,912.30 / $15,867.77 / $31,039.72
| Facility | | $10,912.30 | $15,867.77 | $31,039.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,162.24 / $15,790.74 / $32,739.47
| Facility | | $6,162.24 | $15,790.74 | $32,739.47 |