- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,213.00 / $37,997.19
| Facility | | $4,804.00 | $13,213.00 | $37,997.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,256.61 / $25,997.60 / $32,047.90
| Facility | | $23,256.61 | $25,997.60 | $32,047.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $24,602.88
| Facility | | $688.00 | $3,027.00 | $24,602.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,390.99 / $22,627.35 / $40,524.75
| Facility | | $14,390.99 | $22,627.35 | $40,524.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,421.60 / $53,069.04 / $53,069.04
| Facility | | $32,421.60 | $53,069.04 | $53,069.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,799.96 / $20,716.59 / $40,524.75
| Facility | | $14,799.96 | $20,716.59 | $40,524.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,081.00 / $18,772.32 / $42,418.74
| Facility | | $7,081.00 | $18,772.32 | $42,418.74 |