- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,764.00 / $19,981.59 / $35,106.80
| Facility | | $2,764.00 | $19,981.59 | $35,106.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,701.00 / $23,470.35 / $33,427.19
| Facility | | $8,701.00 | $23,470.35 | $33,427.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $1,262.00 / $2,426.00
| Facility | | $500.00 | $1,262.00 | $2,426.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,323.00 / $17,027.00 / $36,800.93
| Facility | | $2,323.00 | $17,027.00 | $36,800.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,003.50 / $47,474.15 / $47,474.15
| Facility | | $29,003.50 | $47,474.15 | $47,474.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.00 / $17,406.25 / $37,442.05
| Facility | | $2,960.00 | $17,406.25 | $37,442.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $3,101.00 / $25,918.92
| Facility | | $750.00 | $3,101.00 | $25,918.92 |