- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,213.00 / $27,598.50
| Facility | | $4,804.00 | $17,213.00 | $27,598.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,986.41 / $19,986.41 / $19,986.41
| Facility | | $19,986.41 | $19,986.41 | $19,986.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $17,412.38
| Facility | | $687.00 | $2,767.00 | $17,412.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,646.16 / $18,167.25 / $33,123.01
| Facility | | $10,646.16 | $18,167.25 | $33,123.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,708.80 / $37,170.72 / $37,170.72
| Facility | | $22,708.80 | $37,170.72 | $37,170.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,749.64 / $15,424.46 / $36,228.61
| Facility | | $10,749.64 | $15,424.46 | $36,228.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,747.85 / $13,634.88 / $31,172.74
| Facility | | $4,747.85 | $13,634.88 | $31,172.74 |