- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $23,870.00 / $37,317.10
| Facility | | $4,804.00 | $23,870.00 | $37,317.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,221.76 / $23,810.17 / $25,522.46
| Facility | | $10,221.76 | $23,810.17 | $25,522.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $24,161.64
| Facility | | $688.00 | $3,027.00 | $24,161.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,133.41 / $23,210.00 / $39,799.41
| Facility | | $14,133.41 | $23,210.00 | $39,799.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,488.70 / $51,542.03 / $51,542.03
| Facility | | $31,488.70 | $51,542.03 | $51,542.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,535.06 / $20,576.25 / $39,799.41
| Facility | | $14,535.06 | $20,576.25 | $39,799.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $18,436.32 / $42,150.04
| Facility | | $5,257.00 | $18,436.32 | $42,150.04 |