- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $18,524.00 / $28,777.30
| Facility | | $4,804.00 | $18,524.00 | $28,777.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,793.57 / $18,019.28 / $19,732.80
| Facility | | $7,793.57 | $18,019.28 | $19,732.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $18,156.00
| Facility | | $688.00 | $3,027.00 | $18,156.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,899.07 / $17,611.00 / $30,691.55
| Facility | | $10,899.07 | $17,611.00 | $30,691.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,437.80 / $40,000.82 / $40,000.82
| Facility | | $24,437.80 | $40,000.82 | $40,000.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,166.00 / $15,867.50 / $30,691.55
| Facility | | $11,166.00 | $15,867.50 | $30,691.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,950.66 / $14,217.28 / $32,504.26
| Facility | | $4,950.66 | $14,217.28 | $32,504.26 |