- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $30,320.90 / $47,405.20
| Facility | | $4,804.00 | $30,320.90 | $47,405.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,532.81 / $31,532.81 / $33,895.26
| Facility | | $31,532.81 | $31,532.81 | $33,895.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $31,905.03
| Facility | | $688.00 | $3,030.00 | $31,905.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,397.95 / $31,015.20 / $62,860.56
| Facility | | $17,397.95 | $31,015.20 | $62,860.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,297.10 / $65,959.99 / $65,959.99
| Facility | | $40,297.10 | $65,959.99 | $65,959.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,464.41 / $26,138.75 / $62,860.56
| Facility | | $18,464.41 | $26,138.75 | $62,860.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,956.18 / $26,180.57 / $46,579.25
| Facility | | $8,956.18 | $26,180.57 | $46,579.25 |