- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,130.00 / $29,670.50
| Facility | | $4,804.00 | $18,130.00 | $29,670.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,926.39 / $16,108.08 / $17,991.62
| Facility | | $12,926.39 | $16,108.08 | $17,991.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $19,641.82
| Facility | | $688.00 | $3,030.00 | $19,641.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,237.36 / $18,454.00 / $34,499.97
| Facility | | $11,237.36 | $18,454.00 | $34,499.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,919.10 / $39,151.79 / $39,151.79
| Facility | | $23,919.10 | $39,151.79 | $39,151.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,890.32 / $8,890.32 / $8,890.32
| Facility | | $8,890.32 | $8,890.32 | $8,890.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,556.70 / $16,360.00 / $37,734.01
| Facility | | $11,556.70 | $16,360.00 | $37,734.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,104.32 / $14,658.56 / $33,513.12
| Facility | | $5,104.32 | $14,658.56 | $33,513.12 |