- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $19,736.00 / $32,733.20
| Facility | | $4,804.00 | $19,736.00 | $32,733.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,732.25 / $20,160.43 / $22,056.54
| Facility | | $17,732.25 | $20,160.43 | $22,056.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $20,628.75
| Facility | | $687.00 | $2,767.00 | $20,628.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,626.91 / $21,658.50 / $40,403.21
| Facility | | $12,626.91 | $21,658.50 | $40,403.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,037.60 / $42,619.44 / $42,619.44
| Facility | | $26,037.60 | $42,619.44 | $42,619.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,640.72 / $35,640.72 / $35,640.72
| Facility | | $35,640.72 | $35,640.72 | $35,640.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,701.00 / $18,294.21 / $43,405.08
| Facility | | $12,701.00 | $18,294.21 | $43,405.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,184.22 / $18,388.07 / $39,483.44
| Facility | | $6,184.22 | $18,388.07 | $39,483.44 |