- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $26,945.60 / $40,685.80
| Facility | | $4,804.00 | $26,945.60 | $40,685.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,934.27 / $25,247.31 / $35,302.66
| Facility | | $19,934.27 | $25,247.31 | $35,302.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $27,571.23
| Facility | | $688.00 | $3,027.00 | $27,571.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,409.29 / $25,305.00 / $46,004.00
| Facility | | $15,409.29 | $25,305.00 | $46,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,917.60 / $58,791.44 / $58,791.44
| Facility | | $35,917.60 | $58,791.44 | $58,791.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,400.00 / $5,624.96 / $35,901.98
| Facility | | $4,400.00 | $5,624.96 | $35,901.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,847.20 / $22,433.75 / $46,004.00
| Facility | | $15,847.20 | $22,433.75 | $46,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $20,100.64 / $45,955.09
| Facility | | $5,257.00 | $20,100.64 | $45,955.09 |