- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.00 / $1,337.00 / $36,988.10
| Facility | | $1,337.00 | $1,337.00 | $36,988.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $24,477.31 / $45,760.44
| Facility | | $1,346.00 | $24,477.31 | $45,760.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,239.22 / $5,727.83 / $27,713.04
| Facility | | $4,239.22 | $5,727.83 | $27,713.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,836.41 / $36,641.08 / $59,976.17
| Facility | | $22,836.41 | $36,641.08 | $59,976.17 |
- 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
- $287.98 / $18,117.70 / $25,926.71
| Facility | | $287.98 | $18,117.70 | $25,926.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,986.72 / $36,199.83 / $42,543.88
| Facility | | $25,986.72 | $36,199.83 | $42,543.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,784.42 / $38,326.64 / $48,674.09
| Facility | | $21,784.42 | $38,326.64 | $48,674.09 |