- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $29,492.00 / $44,530.70
| Facility | | $4,804.00 | $29,492.00 | $44,530.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,078.83 / $36,078.83 / $36,078.83
| Facility | | $36,078.83 | $36,078.83 | $36,078.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,860.00 / $30,453.56
| Facility | | $687.00 | $2,860.00 | $30,453.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,696.55 / $27,364.66 / $51,778.95
| Facility | | $16,696.55 | $27,364.66 | $51,778.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,467.50 / $67,875.75 / $67,875.75
| Facility | | $41,467.50 | $67,875.75 | $67,875.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,906.00 / $24,278.75 / $56,632.73
| Facility | | $16,906.00 | $24,278.75 | $56,632.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,257.00 / $22,000.16 / $50,093.58
| Facility | | $5,257.00 | $22,000.16 | $50,093.58 |