- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,082.00 / $32,300.20
| Facility | | $4,804.00 | $21,082.00 | $32,300.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,555.62 / $27,555.62 / $28,005.06
| Facility | | $27,555.62 | $27,555.62 | $28,005.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $21,280.75
| Facility | | $688.00 | $3,027.00 | $21,280.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,233.33 / $20,090.00 / $34,448.81
| Facility | | $12,233.33 | $20,090.00 | $34,448.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,806.50 / $45,514.85 / $45,514.85
| Facility | | $27,806.50 | $45,514.85 | $45,514.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,433.50 / $9,433.50 / $9,433.50
| Facility | | $9,433.50 | $9,433.50 | $9,433.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,580.98 / $17,810.00 / $34,448.81
| Facility | | $12,580.98 | $17,810.00 | $34,448.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $15,957.76 / $36,483.43
| Facility | | $5,257.00 | $15,957.76 | $36,483.43 |