- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,029.80 / $37,793.19
| Facility | | $4,804.00 | $25,029.80 | $37,793.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,421.03 / $24,987.25 / $25,899.62
| Facility | | $21,421.03 | $24,987.25 | $25,899.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $25,328.10
| Facility | | $687.00 | $2,767.00 | $25,328.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,313.72 / $22,577.54 / $40,307.14
| Facility | | $14,313.72 | $22,577.54 | $40,307.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,377.30 / $54,633.37 / $54,633.37
| Facility | | $33,377.30 | $54,633.37 | $54,633.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,720.49 / $20,838.75 / $40,307.14
| Facility | | $14,720.49 | $20,838.75 | $40,307.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,432.00 / $18,339.77 / $42,514.38
| Facility | | $4,432.00 | $18,339.77 | $42,514.38 |