- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,697.00 / $27,421.60
| Facility | | $4,804.00 | $17,697.00 | $27,421.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,368.01 / $18,511.28 / $27,165.72
| Facility | | $7,368.01 | $18,511.28 | $27,165.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $17,866.53
| Facility | | $687.00 | $2,767.00 | $17,866.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,577.95 / $18,144.00 / $33,213.19
| Facility | | $10,577.95 | $18,144.00 | $33,213.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,345.30 / $38,212.57 / $38,212.57
| Facility | | $23,345.30 | $38,212.57 | $38,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,684.82 / $35,518.41 / $55,717.57
| Facility | | $7,684.82 | $35,518.41 | $55,717.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,680.77 / $15,325.63 / $35,996.49
| Facility | | $10,680.77 | $15,325.63 | $35,996.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,717.43 / $13,547.52 / $30,973.02
| Facility | | $4,717.43 | $13,547.52 | $30,973.02 |