- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,809.59 / $26,891.20
| Facility | | $4,804.00 | $17,809.59 | $26,891.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,002.07 / $16,002.07 / $17,706.84
| Facility | | $16,002.07 | $16,002.07 | $17,706.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $18,594.06
| Facility | | $688.00 | $3,030.00 | $18,594.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,184.70 / $16,725.00 / $31,268.23
| Facility | | $10,184.70 | $16,725.00 | $31,268.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,660.70 / $38,728.83 / $38,728.83
| Facility | | $23,660.70 | $38,728.83 | $38,728.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,353.33 / $18,576.65 / $43,365.75
| Facility | | $17,353.33 | $18,576.65 | $43,365.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,474.15 / $14,827.50 / $34,199.33
| Facility | | $10,474.15 | $14,827.50 | $34,199.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,893.08 / $13,285.44 / $30,373.84
| Facility | | $4,893.08 | $13,285.44 | $30,373.84 |