- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $26,187.00 / $41,023.60
| Facility | | $4,804.00 | $26,187.00 | $41,023.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,039.13 / $22,039.13 / $22,039.13
| Facility | | $22,039.13 | $22,039.13 | $22,039.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $26,216.25
| Facility | | $688.00 | $3,030.00 | $26,216.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,537.23 / $25,515.00 / $47,701.06
| Facility | | $15,537.23 | $25,515.00 | $47,701.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,547.69 / $56,549.13 / $56,549.13
| Facility | | $34,547.69 | $56,549.13 | $56,549.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,691.90 / $63,691.90 / $63,691.90
| Facility | | $63,691.90 | $63,691.90 | $63,691.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,917.00 / $22,620.00 / $52,172.58
| Facility | | $15,917.00 | $22,620.00 | $52,172.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,057.44 / $21,431.00 / $40,308.83
| Facility | | $7,057.44 | $21,431.00 | $40,308.83 |