- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,525.00 / $18,108.80
| Facility | | $4,804.00 | $11,525.00 | $18,108.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,606.00 / $13,121.77 / $20,786.49
| Facility | | $10,606.00 | $13,121.77 | $20,786.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,771.00 / $11,553.05
| Facility | | $688.00 | $2,771.00 | $11,553.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,858.50 / $11,128.08 / $19,313.39
| Facility | | $6,858.50 | $11,128.08 | $19,313.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,201.90 / $24,883.11 / $24,883.11
| Facility | | $15,201.90 | $24,883.11 | $24,883.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,665.09 / $23,516.96 / $36,535.50
| Facility | | $5,665.09 | $23,516.96 | $36,535.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,026.00 / $9,985.00 / $19,313.39
| Facility | | $7,026.00 | $9,985.00 | $19,313.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $8,946.56 / $20,454.07
| Facility | | $3,775.00 | $8,946.56 | $20,454.07 |