- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $14,825.00 / $23,146.10
| Facility | | $4,804.00 | $14,825.00 | $23,146.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,157.97 / $15,563.36 / $21,675.04
| Facility | | $11,157.97 | $15,563.36 | $21,675.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $14,967.43
| Facility | | $688.00 | $3,027.00 | $14,967.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,766.31 / $14,396.00 / $26,288.00
| Facility | | $8,766.31 | $14,396.00 | $26,288.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,784.73 / $27,276.45 / $32,011.23
| Facility | | $18,784.73 | $27,276.45 | $32,011.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,277.98 / $23,967.02 / $86,400.01
| Facility | | $18,277.98 | $23,967.02 | $86,400.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,015.43 / $12,762.50 / $26,288.00
| Facility | | $9,015.43 | $12,762.50 | $26,288.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.63 / $11,435.20 / $26,143.73
| Facility | | $4,211.63 | $11,435.20 | $26,143.73 |