- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $19,201.00 / $30,491.20
| Facility | | $4,804.00 | $19,201.00 | $30,491.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,519.47 / $17,519.47 / $17,519.47
| Facility | | $17,519.47 | $17,519.47 | $17,519.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $20,048.20
| Facility | | $688.00 | $3,030.00 | $20,048.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,057.00 / $17,947.68 / $35,454.19
| Facility | | $10,057.00 | $17,947.68 | $35,454.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,330.80 / $41,462.51 / $41,462.51
| Facility | | $25,330.80 | $41,462.51 | $41,462.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,586.64 / $32,586.64 / $32,586.64
| Facility | | $32,586.64 | $32,586.64 | $32,586.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,432.50 / $16,354.00 / $38,777.69
| Facility | | $11,432.50 | $16,354.00 | $38,777.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,855.00 / $17,128.58 / $36,879.90
| Facility | | $5,855.00 | $17,128.58 | $36,879.90 |