- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,975.00 / $43,728.20
| Facility | | $4,804.00 | $21,975.00 | $43,728.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,154.93 / $27,345.69 / $60,348.56
| Facility | | $20,154.93 | $27,345.69 | $60,348.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.00 / $2,753.00 / $31,025.90
| Facility | | $676.00 | $2,753.00 | $31,025.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,502.84 / $30,943.41 / $57,402.14
| Facility | | $17,502.84 | $30,943.41 | $57,402.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,824.50 / $58,639.05 / $58,639.05
| Facility | | $35,824.50 | $58,639.05 | $58,639.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,003.00 / $106,045.26 / $153,089.12
| Facility | | $19,003.00 | $106,045.26 | $153,089.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,360.09 / $27,004.60 / $57,984.66
| Facility | | $17,360.09 | $27,004.60 | $57,984.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,258.71 / $23,582.73 / $52,745.77
| Facility | | $9,258.71 | $23,582.73 | $52,745.77 |