- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,557.00 / $31,577.00
| Facility | | $4,804.00 | $18,557.00 | $31,577.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,722.45 / $16,722.45 / $16,722.45
| Facility | | $16,722.45 | $16,722.45 | $16,722.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $19,720.25
| Facility | | $688.00 | $3,030.00 | $19,720.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,959.44 / $19,640.00 / $37,898.01
| Facility | | $11,959.44 | $19,640.00 | $37,898.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,513.30 / $34,142.60 / $40,069.24
| Facility | | $23,513.30 | $34,142.60 | $40,069.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,252.00 / $17,411.25 / $40,158.69
| Facility | | $12,252.00 | $17,411.25 | $40,158.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $15,600.48 / $35,666.60
| Facility | | $5,257.00 | $15,600.48 | $35,666.60 |