- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,112.92 / $6,470.00 / $27,982.24
| Facility | | $2,112.92 | $6,470.00 | $27,982.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,866.94 / $16,595.73 / $31,745.76
| Facility | | $9,866.94 | $16,595.73 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,147.74 / $4,147.74 / $6,910.09
| Facility | | $4,147.74 | $4,147.74 | $6,910.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,885.80 / $3,205.76 / $11,234.92
| Facility | | $1,885.80 | $3,205.76 | $11,234.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,025.60 / $2,771.12 / $2,989.96
| Facility | | $2,025.60 | $2,771.12 | $2,989.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,019.93 / $2,031.37 / $2,513.62
| Facility | | $2,019.93 | $2,031.37 | $2,513.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,761.59 / $16,586.25 / $31,745.76
| Facility | | $10,761.59 | $16,586.25 | $31,745.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,312.00 / $21,157.82 / $33,842.43
| Facility | | $10,312.00 | $21,157.82 | $33,842.43 |