- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $24,501.00 / $38,140.00
| Facility | | $4,804.00 | $24,501.00 | $38,140.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,241.43 / $26,634.85 / $31,762.14
| Facility | | $12,241.43 | $26,634.85 | $31,762.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $25,924.76
| Facility | | $688.00 | $3,030.00 | $25,924.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,579.00 / $22,449.95 / $44,348.06
| Facility | | $12,579.00 | $22,449.95 | $44,348.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,320.90 / $52,904.21 / $52,904.21
| Facility | | $32,320.90 | $52,904.21 | $52,904.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,111.42 / $43,111.42 / $43,111.42
| Facility | | $43,111.42 | $43,111.42 | $43,111.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,697.92 / $20,380.59 / $48,505.27
| Facility | | $14,697.92 | $20,380.59 | $48,505.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $18,842.88 / $42,904.56
| Facility | | $5,257.00 | $18,842.88 | $42,904.56 |