- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,046.00 / $21,334.70
| Facility | | $4,804.00 | $13,046.00 | $21,334.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,493.82 / $10,806.47 / $14,189.93
| Facility | | $6,493.82 | $10,806.47 | $14,189.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,910.00 / $13,059.82
| Facility | | $688.00 | $2,910.00 | $13,059.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,080.28 / $13,270.00 / $22,753.92
| Facility | | $8,080.28 | $13,270.00 | $22,753.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,210.20 / $28,170.38 / $28,170.38
| Facility | | $17,210.20 | $28,170.38 | $28,170.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,043.00 / $5,043.00 / $35,506.80
| Facility | | $5,043.00 | $5,043.00 | $35,506.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,278.00 / $11,763.75 / $22,753.92
| Facility | | $8,278.00 | $11,763.75 | $22,753.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,882.04 / $10,540.32 / $23,999.93
| Facility | | $3,882.04 | $10,540.32 | $23,999.93 |