- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $28,489.00 / $46,852.10
| Facility | | $4,804.00 | $28,489.00 | $46,852.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $29,749.65
| Facility | | $688.00 | $3,030.00 | $29,749.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,744.68 / $28,791.20 / $54,478.21
| Facility | | $17,744.68 | $28,791.20 | $54,478.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,583.90 / $61,518.91 / $61,518.91
| Facility | | $37,583.90 | $61,518.91 | $61,518.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,736.59 / $56,736.59 / $56,736.59
| Facility | | $56,736.59 | $56,736.59 | $56,736.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,248.96 / $25,833.75 / $59,585.03
| Facility | | $18,248.96 | $25,833.75 | $59,585.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $23,147.04 / $52,919.92
| Facility | | $5,257.00 | $23,147.04 | $52,919.92 |