- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $15,054.50 / $22,731.20
| Facility | | $4,804.00 | $15,054.50 | $22,731.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,411.66 / $15,909.94 / $23,179.62
| Facility | | $12,411.66 | $15,909.94 | $23,179.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $3,059.00 / $14,702.46
| Facility | | $687.00 | $3,059.00 | $14,702.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,522.95 / $13,968.61 / $26,431.17
| Facility | | $8,522.95 | $13,968.61 | $26,431.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,444.00 / $33,463.60 / $33,463.60
| Facility | | $20,444.00 | $33,463.60 | $33,463.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,973.20 / $3,973.20 / $23,446.52
| Facility | | $3,973.20 | $3,973.20 | $23,446.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,625.95 / $12,393.37 / $28,908.84
| Facility | | $8,625.95 | $12,393.37 | $28,908.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,910.53 / $11,030.70 / $25,570.86
| Facility | | $3,910.53 | $11,030.70 | $25,570.86 |