- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $21,100.20 / $41,594.90
| Facility | | $4,804.00 | $21,100.20 | $41,594.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,058.19 / $26,293.86 / $34,829.99
| Facility | | $22,058.19 | $26,293.86 | $34,829.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $25,713.08
| Facility | | $688.00 | $3,030.00 | $25,713.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,480.00 / $24,325.78 / $48,365.33
| Facility | | $10,480.00 | $24,325.78 | $48,365.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,707.30 / $56,810.37 / $56,810.37
| Facility | | $34,707.30 | $56,810.37 | $56,810.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,073.04 / $22,270.82 / $125,357.61
| Facility | | $19,073.04 | $22,270.82 | $125,357.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,595.80 / $22,226.77 / $52,899.12
| Facility | | $15,595.80 | $22,226.77 | $52,899.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,081.00 / $20,184.63 / $40,870.17
| Facility | | $7,081.00 | $20,184.63 | $40,870.17 |