- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,286.00 / $40,642.80
| Facility | | $4,804.00 | $25,286.00 | $40,642.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,807.59 / $29,055.60 / $31,594.49
| Facility | | $22,807.59 | $29,055.60 | $31,594.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.00 / $2,690.00 / $24,608.60
| Facility | | $652.00 | $2,690.00 | $24,608.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,916.10 / $24,202.80 / $47,258.21
| Facility | | $14,916.10 | $24,202.80 | $47,258.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,345.00 / $54,580.50 / $54,580.50
| Facility | | $33,345.00 | $54,580.50 | $54,580.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,769.00 / $22,159.01 / $51,688.22
| Facility | | $15,769.00 | $22,159.01 | $51,688.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,678.56 / $19,839.00 / $39,934.62
| Facility | | $7,678.56 | $19,839.00 | $39,934.62 |