- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $15,382.00 / $24,123.10
| Facility | | $4,804.00 | $15,382.00 | $24,123.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $14,570.52
| Facility | | $675.00 | $2,690.00 | $14,570.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.85 / $14,411.11 / $27,500.60
| Facility | | $9,044.85 | $14,411.11 | $27,500.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,293.90 / $33,217.91 / $33,217.91
| Facility | | $20,293.90 | $33,217.91 | $33,217.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,962.82 / $21,962.82 / $21,962.82
| Facility | | $21,962.82 | $21,962.82 | $21,962.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,360.00 / $13,152.28 / $30,679.07
| Facility | | $9,360.00 | $13,152.28 | $30,679.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,389.41 / $11,917.92 / $27,136.68
| Facility | | $4,389.41 | $11,917.92 | $27,136.68 |