- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.00 / $33,018.24 / $50,171.60
| Facility | | $4,002.00 | $33,018.24 | $50,171.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,812.00 / $5,812.00 / $6,916.00
| Facility | | $5,812.00 | $5,812.00 | $6,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,220.40 / $34,072.08 / $39,935.01
| Facility | | $28,220.40 | $34,072.08 | $39,935.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $30,265.10 / $39,311.16
| Facility | | $2,400.00 | $30,265.10 | $39,311.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,019.47 / $37,340.10 / $54,587.67
| Facility | | $19,019.47 | $37,340.10 | $54,587.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,143.00 / $30,282.90
| Facility | | $1,500.00 | $2,143.00 | $30,282.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $34,210.94 / $49,281.62
| Facility | | $3,775.00 | $34,210.94 | $49,281.62 |