- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.00 / $1,337.00 / $35,045.40
| Facility | | $1,337.00 | $1,337.00 | $35,045.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $25,259.38 / $47,222.54
| Facility | | $1,346.00 | $25,259.38 | $47,222.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,016.56 / $5,426.99 / $26,257.48
| Facility | | $4,016.56 | $5,426.99 | $26,257.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,636.99 / $34,716.60 / $56,826.07
| Facility | | $21,636.99 | $34,716.60 | $56,826.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,683.67 / $6,683.67 / $6,683.67
| Facility | | $6,683.67 | $6,683.67 | $6,683.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $297.18 / $18,696.58 / $26,755.10
| Facility | | $297.18 | $18,696.58 | $26,755.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,621.83 / $34,298.51 / $40,309.37
| Facility | | $24,621.83 | $34,298.51 | $40,309.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,221.20 / $36,584.39 / $46,117.60
| Facility | | $22,221.20 | $36,584.39 | $46,117.60 |