- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,398.00 / $33,372.50
| Facility | | $4,804.00 | $21,398.00 | $33,372.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $20,371.34
| Facility | | $675.00 | $2,690.00 | $20,371.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,639.45 / $19,936.65 / $35,592.43
| Facility | | $12,639.45 | $19,936.65 | $35,592.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,228.30 / $46,205.27 / $46,205.27
| Facility | | $28,228.30 | $46,205.27 | $46,205.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,514.13 / $7,514.13 / $7,514.13
| Facility | | $7,514.13 | $7,514.13 | $7,514.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,949.00 / $18,401.25 / $35,592.43
| Facility | | $12,949.00 | $18,401.25 | $35,592.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,860.99 / $37,255.91
| Facility | | $5,257.00 | $17,860.99 | $37,255.91 |