- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,557.00 / $26,514.80
| Facility | | $4,804.00 | $17,557.00 | $26,514.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $17,608.16
| Facility | | $688.00 | $3,030.00 | $17,608.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,042.19 / $16,491.00 / $31,822.48
| Facility | | $10,042.19 | $16,491.00 | $31,822.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,162.90 / $37,914.01 / $37,914.01
| Facility | | $23,162.90 | $37,914.01 | $37,914.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,754.33 / $12,754.33 / $12,754.33
| Facility | | $12,754.33 | $12,754.33 | $12,754.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,288.00 / $14,620.00 / $33,720.74
| Facility | | $10,288.00 | $14,620.00 | $33,720.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,561.43 / $13,099.52 / $29,827.14
| Facility | | $4,561.43 | $13,099.52 | $29,827.14 |