- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $12,374.00 / $19,110.80
| Facility | | $4,804.00 | $12,374.00 | $19,110.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,346.73 / $13,132.64 / $15,678.48
| Facility | | $6,346.73 | $13,132.64 | $15,678.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,957.38 / $12,867.60
| Facility | | $688.00 | $2,957.38 | $12,867.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,238.00 / $11,886.00 / $22,221.48
| Facility | | $7,238.00 | $11,886.00 | $22,221.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,322.90 / $26,718.01 / $26,718.01
| Facility | | $16,322.90 | $26,718.01 | $26,718.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,921.15 / $16,921.15 / $18,541.52
| Facility | | $16,921.15 | $16,921.15 | $18,541.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,443.69 / $10,537.50 / $24,304.53
| Facility | | $7,443.69 | $10,537.50 | $24,304.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,441.60 / $21,585.86
| Facility | | $3,775.00 | $9,441.60 | $21,585.86 |