- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $30,901.40 / $54,292.40
| Facility | | $4,804.00 | $30,901.40 | $54,292.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,641.27 / $25,641.27 / $30,040.43
| Facility | | $25,641.27 | $25,641.27 | $30,040.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $910.00 / $2,308.00 / $37,437.33
| Facility | | $910.00 | $2,308.00 | $37,437.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,562.61 / $33,768.00 / $63,129.56
| Facility | | $20,562.61 | $33,768.00 | $63,129.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,146.97 / $29,936.25 / $69,047.36
| Facility | | $21,146.97 | $29,936.25 | $69,047.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $26,822.88 / $61,323.81
| Facility | | $5,257.00 | $26,822.88 | $61,323.81 |