- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $23,943.00 / $37,643.50
| Facility | | $4,804.00 | $23,943.00 | $37,643.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $24,480.26
| Facility | | $688.00 | $3,030.00 | $24,480.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,257.05 / $23,413.00 / $43,770.78
| Facility | | $14,257.05 | $23,413.00 | $43,770.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,587.50 / $51,703.75 / $51,703.75
| Facility | | $31,587.50 | $51,703.75 | $51,703.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,662.22 / $20,756.25 / $47,873.88
| Facility | | $14,662.22 | $20,756.25 | $47,873.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,849.56 / $21,486.87 / $45,530.91
| Facility | | $6,849.56 | $21,486.87 | $45,530.91 |