- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,402.00 / $25,528.70
| Facility | | $4,804.00 | $16,402.00 | $25,528.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,079.50 / $19,041.25 / $22,264.02
| Facility | | $8,079.50 | $19,041.25 | $22,264.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $16,374.51
| Facility | | $688.00 | $3,027.00 | $16,374.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,668.69 / $15,202.35 / $27,226.85
| Facility | | $9,668.69 | $15,202.35 | $27,226.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,635.30 / $35,413.57 / $35,413.57
| Facility | | $21,635.30 | $35,413.57 | $35,413.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,529.30 / $18,992.24 / $19,662.50
| Facility | | $15,529.30 | $18,992.24 | $19,662.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,905.00 / $14,024.00 / $27,226.85
| Facility | | $9,905.00 | $14,024.00 | $27,226.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,432.00 / $12,612.32 / $28,717.80
| Facility | | $4,432.00 | $12,612.32 | $28,717.80 |