- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $28,781.00 / $46,713.80
| Facility | | $4,804.00 | $28,781.00 | $46,713.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,217.51 / $27,217.51 / $27,651.45
| Facility | | $27,217.51 | $27,217.51 | $27,651.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $29,381.44
| Facility | | $688.00 | $3,030.00 | $29,381.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,692.31 / $29,054.00 / $54,317.42
| Facility | | $17,692.31 | $29,054.00 | $54,317.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,969.60 / $62,150.24 / $62,150.24
| Facility | | $37,969.60 | $62,150.24 | $62,150.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,195.09 / $25,757.50 / $59,409.16
| Facility | | $18,195.09 | $25,757.50 | $59,409.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,432.00 / $22,207.09 / $52,549.42
| Facility | | $4,432.00 | $22,207.09 | $52,549.42 |