- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,221.00 / $43,676.00
| Facility | | $4,804.00 | $25,221.00 | $43,676.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,870.00 / $26,088.84
| Facility | | $687.00 | $2,870.00 | $26,088.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,339.00 / $28,575.33 / $52,418.93
| Facility | | $16,339.00 | $28,575.33 | $52,418.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,272.80 / $54,462.32 / $54,462.32
| Facility | | $33,272.80 | $54,462.32 | $54,462.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $96,942.54 / $96,942.54 / $96,942.54
| Facility | | $96,942.54 | $96,942.54 | $96,942.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,376.10 / $24,082.50 / $57,333.69
| Facility | | $16,376.10 | $24,082.50 | $57,333.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,432.00 / $21,194.53 / $49,132.15
| Facility | | $4,432.00 | $21,194.53 | $49,132.15 |