- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,751.00 / $26,755.10
| Facility | | $4,804.00 | $16,751.00 | $26,755.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,825.97 / $16,825.97 / $40,937.15
| Facility | | $16,825.97 | $16,825.97 | $40,937.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $17,959.49
| Facility | | $688.00 | $3,030.00 | $17,959.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,819.26 / $16,641.00 / $32,110.88
| Facility | | $9,819.26 | $16,641.00 | $32,110.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,098.90 / $36,172.41 / $36,172.41
| Facility | | $22,098.90 | $36,172.41 | $36,172.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,381.00 / $14,752.50 / $34,026.35
| Facility | | $10,381.00 | $14,752.50 | $34,026.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,602.78 / $13,218.24 / $30,220.20
| Facility | | $4,602.78 | $13,218.24 | $30,220.20 |