- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $27,083.80 / $40,894.40
| Facility | | $4,804.00 | $27,083.80 | $40,894.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,296.56 / $36,315.37 / $36,734.06
| Facility | | $36,296.56 | $36,315.37 | $36,734.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $30,645.12
| Facility | | $688.00 | $3,030.00 | $30,645.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,008.45 / $24,352.65 / $47,550.80
| Facility | | $15,008.45 | $24,352.65 | $47,550.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,487.00 / $61,360.30 / $61,360.30
| Facility | | $37,487.00 | $61,360.30 | $61,360.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,867.00 / $22,296.20 / $52,008.24
| Facility | | $15,867.00 | $22,296.20 | $52,008.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,726.10 / $19,440.63 / $40,181.87
| Facility | | $7,726.10 | $19,440.63 | $40,181.87 |