- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $19,641.30 / $29,656.90
| Facility | | $4,804.00 | $19,641.30 | $29,656.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,939.01 / $19,571.73 / $30,033.18
| Facility | | $15,939.01 | $19,571.73 | $30,033.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $18,995.02
| Facility | | $687.00 | $2,767.00 | $18,995.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,449.37 / $19,841.47 / $35,593.51
| Facility | | $11,449.37 | $19,841.47 | $35,593.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,143.30 / $39,518.76 / $39,518.76
| Facility | | $24,143.30 | $39,518.76 | $39,518.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,870.80 / $24,870.80 / $24,870.80
| Facility | | $24,870.80 | $24,870.80 | $24,870.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,551.41 / $17,078.55 / $38,930.72
| Facility | | $11,551.41 | $17,078.55 | $38,930.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,101.97 / $14,651.84 / $33,497.76
| Facility | | $5,101.97 | $14,651.84 | $33,497.76 |