- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,890.16 / $20,357.00 / $34,582.69
| Facility | | $9,890.16 | $20,357.00 | $34,582.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,166.56 / $34,326.14 / $46,247.06
| Facility | | $23,166.56 | $34,326.14 | $46,247.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.00 / $3,500.00 / $3,500.00
| Facility | | $3,500.00 | $3,500.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,913.15 / $27,753.07 / $44,374.23
| Facility | | $14,913.15 | $27,753.07 | $44,374.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,559.59 / $29,898.13 / $62,697.32
| Facility | | $15,559.59 | $29,898.13 | $62,697.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,647.00 / $29,700.69 / $44,385.19
| Facility | | $17,647.00 | $29,700.69 | $44,385.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $20,055.45 / $38,174.01
| Facility | | $5,281.00 | $20,055.45 | $38,174.01 |