- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $29,133.00 / $44,653.10
| Facility | | $4,804.00 | $29,133.00 | $44,653.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,326.21 / $22,636.56 / $28,239.28
| Facility | | $21,326.21 | $22,636.56 | $28,239.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $29,447.51
| Facility | | $688.00 | $3,027.00 | $29,447.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,911.84 / $26,675.65 / $47,623.41
| Facility | | $16,911.84 | $26,675.65 | $47,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,425.60 / $62,896.64 / $62,896.64
| Facility | | $38,425.60 | $62,896.64 | $62,896.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210,779.12 / $210,779.12 / $210,779.12
| Facility | | $210,779.12 | $210,779.12 | $210,779.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,392.45 / $24,621.25 / $47,623.41
| Facility | | $17,392.45 | $24,621.25 | $47,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $22,060.64 / $50,436.14
| Facility | | $5,257.00 | $22,060.64 | $50,436.14 |