- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,732.09 / $31,460.80 / $43,899.60
| Facility | | $17,732.09 | $31,460.80 | $43,899.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,658.00 / $8,639.91 / $27,516.06
| Facility | | $1,658.00 | $8,639.91 | $27,516.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,698.09 / $14,698.09 / $31,000.19
| Facility | | $14,698.09 | $14,698.09 | $31,000.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,708.00 / $3,708.00 / $3,708.00
| Facility | | $3,708.00 | $3,708.00 | $3,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,310.67 / $21,057.60 / $53,982.53
| Facility | | $13,310.67 | $21,057.60 | $53,982.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,246.40 / $30,049.00 / $43,443.40
| Facility | | $17,246.40 | $30,049.00 | $43,443.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,698.09 / $14,698.09 / $31,000.19
| Facility | | $14,698.09 | $14,698.09 | $31,000.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $14,470.95 / $20,632.91
| Facility | | $2,621.40 | $14,470.95 | $20,632.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,240.76 / $24,785.21 / $44,957.48
| Facility | | $8,240.76 | $24,785.21 | $44,957.48 |