- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,804.00 / $17,143.09
| Facility | | $4,804.00 | $10,804.00 | $17,143.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,759.00 / $11,236.50
| Facility | | $688.00 | $2,759.00 | $11,236.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,492.73 / $10,662.00 / $18,283.40
| Facility | | $6,492.73 | $10,662.00 | $18,283.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,253.80 / $23,331.22 / $23,331.22
| Facility | | $14,253.80 | $23,331.22 | $23,331.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,819.20 / $26,122.70 / $62,904.47
| Facility | | $18,819.20 | $26,122.70 | $62,904.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,677.25 / $9,452.50 / $18,283.40
| Facility | | $6,677.25 | $9,452.50 | $18,283.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,629.76 / $8,469.44 / $19,363.25
| Facility | | $3,629.76 | $8,469.44 | $19,363.25 |