- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $23,779.00 / $38,151.30
| Facility | | $4,804.00 | $23,779.00 | $38,151.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,146.44 / $24,139.15 / $41,746.83
| Facility | | $21,146.44 | $24,139.15 | $41,746.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $25,161.24
| Facility | | $688.00 | $3,030.00 | $25,161.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,304.65 / $23,729.00 / $44,361.24
| Facility | | $14,304.65 | $23,729.00 | $44,361.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,130.75 / $43,751.50 / $51,346.10
| Facility | | $30,130.75 | $43,751.50 | $51,346.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,219.12 / $61,955.05 / $187,722.00
| Facility | | $36,219.12 | $61,955.05 | $187,722.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,860.01 / $21,036.25 / $48,519.69
| Facility | | $14,860.01 | $21,036.25 | $48,519.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $18,848.48 / $42,917.32
| Facility | | $5,257.00 | $18,848.48 | $42,917.32 |