- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,633.00 / $33,574.30
| Facility | | $4,804.00 | $21,633.00 | $33,574.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,796.26 / $20,706.36 / $25,151.18
| Facility | | $15,796.26 | $20,706.36 | $25,151.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $21,679.57
| Facility | | $688.00 | $3,027.00 | $21,679.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,715.87 / $20,631.81 / $35,807.62
| Facility | | $12,715.87 | $20,631.81 | $35,807.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,536.10 / $46,709.09 / $46,709.09
| Facility | | $28,536.10 | $46,709.09 | $46,709.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,706.77 / $25,641.15 / $76,716.27
| Facility | | $7,706.77 | $25,641.15 | $76,716.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,077.23 / $18,512.50 / $35,807.62
| Facility | | $13,077.23 | $18,512.50 | $35,807.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $16,587.20 / $37,922.49
| Facility | | $5,257.00 | $16,587.20 | $37,922.49 |