- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $22,289.00 / $35,183.80
| Facility | | $4,804.00 | $22,289.00 | $35,183.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,944.84 / $18,944.84 / $19,640.49
| Facility | | $18,944.84 | $18,944.84 | $19,640.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $22,887.53
| Facility | | $688.00 | $3,030.00 | $22,887.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,192.00 / $21,620.91 / $40,910.72
| Facility | | $13,192.00 | $21,620.91 | $40,910.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,402.50 / $48,127.25 / $48,127.25
| Facility | | $29,402.50 | $48,127.25 | $48,127.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,651.00 / $19,182.72 / $44,745.71
| Facility | | $13,651.00 | $19,182.72 | $44,745.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $17,382.40 / $39,740.51
| Facility | | $5,257.00 | $17,382.40 | $39,740.51 |