- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $22,320.00 / $33,708.00
| Facility | | $4,804.00 | $22,320.00 | $33,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,154.22 / $18,968.72 / $22,969.13
| Facility | | $12,154.22 | $18,968.72 | $22,969.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $21,816.43
| Facility | | $688.00 | $3,027.00 | $21,816.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,766.52 / $20,073.15 / $35,950.26
| Facility | | $12,766.52 | $20,073.15 | $35,950.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,444.30 / $48,195.67 / $48,195.67
| Facility | | $29,444.30 | $48,195.67 | $48,195.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,129.33 / $18,378.08 / $35,950.26
| Facility | | $13,129.33 | $18,378.08 | $35,950.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $16,653.28 / $38,073.56
| Facility | | $5,257.00 | $16,653.28 | $38,073.56 |