- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,506.00 / $28,752.40
| Facility | | $4,804.00 | $18,506.00 | $28,752.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,710.13 / $17,999.09 / $22,669.66
| Facility | | $12,710.13 | $17,999.09 | $22,669.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $18,519.91
| Facility | | $688.00 | $3,027.00 | $18,519.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,889.62 / $17,122.05 / $30,664.96
| Facility | | $10,889.62 | $17,122.05 | $30,664.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,405.50 / $39,947.94 / $39,947.94
| Facility | | $24,405.50 | $39,947.94 | $39,947.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,749.90 / $31,793.47 / $73,408.89
| Facility | | $14,749.90 | $31,793.47 | $73,408.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,156.00 / $15,853.75 / $30,664.96
| Facility | | $11,156.00 | $15,853.75 | $30,664.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,946.37 / $14,204.96 / $32,476.09
| Facility | | $4,946.37 | $14,204.96 | $32,476.09 |