- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,998.00 / $34,462.90
| Facility | | $4,804.00 | $21,998.00 | $34,462.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,867.14 / $32,867.14 / $32,867.14
| Facility | | $32,867.14 | $32,867.14 | $32,867.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $22,954.30
| Facility | | $688.00 | $3,030.00 | $22,954.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,052.44 / $21,435.00 / $40,072.47
| Facility | | $13,052.44 | $21,435.00 | $40,072.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,020.60 / $47,502.14 / $47,502.14
| Facility | | $29,020.60 | $47,502.14 | $47,502.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,423.37 / $19,002.50 / $43,828.89
| Facility | | $13,423.37 | $19,002.50 | $43,828.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,026.24 / $38,768.14
| Facility | | $5,257.00 | $17,026.24 | $38,768.14 |