- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $25,873.00 / $47,047.10
| Facility | | $4,804.00 | $25,873.00 | $47,047.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.00 / $1,187.00 / $2,495.00
| Facility | | $577.00 | $1,187.00 | $2,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,677.70 / $44,139.56 / $62,385.59
| Facility | | $18,677.70 | $44,139.56 | $62,385.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,133.50 / $55,871.15 / $55,871.15
| Facility | | $34,133.50 | $55,871.15 | $55,871.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.00 / $1,357.00 / $1,357.00
| Facility | | $1,357.00 | $1,357.00 | $1,357.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,602.40 / $22,413.24 / $62,385.59
| Facility | | $16,602.40 | $22,413.24 | $62,385.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,081.00 / $21,537.88 / $52,521.69
| Facility | | $7,081.00 | $21,537.88 | $52,521.69 |