- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,770.00 / $17,814.09
| Facility | | $4,804.00 | $9,770.00 | $17,814.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,610.05 / $10,082.23
| Facility | | $688.00 | $2,610.05 | $10,082.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.88 / $10,946.98 / $18,999.07
| Facility | | $6,746.88 | $10,946.98 | $18,999.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,887.70 / $21,095.13 / $21,095.13
| Facility | | $12,887.70 | $21,095.13 | $21,095.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,912.00 / $9,822.50 / $18,999.07
| Facility | | $6,912.00 | $9,822.50 | $18,999.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,771.84 / $8,800.95 / $20,039.47
| Facility | | $3,771.84 | $8,800.95 | $20,039.47 |