- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,668.00 / $37,463.00 / $54,112.60
| Facility | | $4,668.00 | $37,463.00 | $54,112.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,809.34 / $21,809.34 / $26,112.08
| Facility | | $21,809.34 | $21,809.34 | $26,112.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,765.00 / $8,192.64 / $41,787.48
| Facility | | $2,765.00 | $8,192.64 | $41,787.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,599.68 / $32,736.01 / $51,639.68
| Facility | | $14,599.68 | $32,736.01 | $51,639.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,708.00 / $4,708.00 / $4,708.00
| Facility | | $4,708.00 | $4,708.00 | $4,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,865.56 / $14,162.82 / $36,387.26
| Facility | | $5,865.56 | $14,162.82 | $36,387.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,825.00 / $37,428.69 / $53,786.90
| Facility | | $7,825.00 | $37,428.69 | $53,786.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,216.88 / $32,008.59 / $51,063.37
| Facility | | $15,216.88 | $32,008.59 | $51,063.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $18,927.30 / $27,228.25
| Facility | | $2,621.40 | $18,927.30 | $27,228.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.00 / $27,480.02 / $52,390.84
| Facility | | $1,850.00 | $27,480.02 | $52,390.84 |