- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $28,780.00 / $45,296.90
| Facility | | $4,804.00 | $28,780.00 | $45,296.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,787.18 / $25,919.84 / $38,710.68
| Facility | | $20,787.18 | $25,919.84 | $38,710.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,870.00 / $29,055.00
| Facility | | $687.00 | $2,870.00 | $29,055.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,473.38 / $29,971.50 / $52,669.92
| Facility | | $17,473.38 | $29,971.50 | $52,669.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,465.33 / $52,949.65 / $62,140.91
| Facility | | $36,465.33 | $52,949.65 | $62,140.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,411.16 / $29,641.75 / $74,254.24
| Facility | | $16,411.16 | $29,641.75 | $74,254.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,643.22 / $25,315.93 / $57,607.22
| Facility | | $17,643.22 | $25,315.93 | $57,607.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $22,378.72 / $51,163.35
| Facility | | $5,257.00 | $22,378.72 | $51,163.35 |