- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $20,441.00 / $33,347.60
| Facility | | $4,804.00 | $20,441.00 | $33,347.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,870.00 / $20,463.47
| Facility | | $687.00 | $2,870.00 | $20,463.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,630.01 / $20,741.00 / $38,775.56
| Facility | | $12,630.01 | $20,741.00 | $38,775.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,966.70 / $44,140.23 / $44,140.23
| Facility | | $26,966.70 | $44,140.23 | $44,140.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,939.00 / $18,387.50 / $42,410.40
| Facility | | $12,939.00 | $18,387.50 | $42,410.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $16,475.20 / $37,513.44
| Facility | | $5,257.00 | $16,475.20 | $37,513.44 |