- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,370.00 / $27,294.70
| Facility | | $4,804.00 | $17,370.00 | $27,294.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,185.33 / $17,455.90 / $26,463.01
| Facility | | $15,185.33 | $17,455.90 | $26,463.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $17,398.64
| Facility | | $688.00 | $3,027.00 | $17,398.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,002.00 / $15,969.86 / $28,611.86
| Facility | | $9,002.00 | $15,969.86 | $28,611.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,912.10 / $37,503.49 / $37,503.49
| Facility | | $22,912.10 | $37,503.49 | $37,503.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,460.00 / $8,526.39 / $18,094.43
| Facility | | $3,460.00 | $8,526.39 | $18,094.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,234.00 / $14,881.44 / $29,110.31
| Facility | | $10,234.00 | $14,881.44 | $29,110.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,695.60 / $13,484.80 / $30,829.62
| Facility | | $4,695.60 | $13,484.80 | $30,829.62 |