- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,643.00 / $29,387.10
| Facility | | $4,804.00 | $18,643.00 | $29,387.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,410.27 / $17,410.27 / $24,033.03
| Facility | | $17,410.27 | $17,410.27 | $24,033.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $19,100.49
| Facility | | $688.00 | $3,027.00 | $19,100.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,130.03 / $18,278.00 / $31,341.94
| Facility | | $11,130.03 | $18,278.00 | $31,341.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,587.90 / $40,246.51 / $40,246.51
| Facility | | $24,587.90 | $40,246.51 | $40,246.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,446.33 / $16,203.75 / $31,341.94
| Facility | | $11,446.33 | $16,203.75 | $31,341.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,055.57 / $14,518.56 / $33,193.06
| Facility | | $5,055.57 | $14,518.56 | $33,193.06 |