- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,921.00 / $26,977.30
| Facility | | $4,804.00 | $16,921.00 | $26,977.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,751.41 / $16,469.08 / $25,315.37
| Facility | | $10,751.41 | $16,469.08 | $25,315.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $16,555.90
| Facility | | $688.00 | $3,027.00 | $16,555.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,898.00 / $15,784.16 / $28,279.16
| Facility | | $8,898.00 | $15,784.16 | $28,279.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,321.20 / $36,536.28 / $36,536.28
| Facility | | $22,321.20 | $36,536.28 | $36,536.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,224.13 / $20,224.13 / $20,224.13
| Facility | | $20,224.13 | $20,224.13 | $20,224.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,115.00 / $14,415.66 / $28,771.82
| Facility | | $10,115.00 | $14,415.66 | $28,771.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,096.77 / $13,030.71 / $30,347.38
| Facility | | $5,096.77 | $13,030.71 | $30,347.38 |