- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $16,186.00 / $22,734.30
| Facility | | $3,000.00 | $16,186.00 | $22,734.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,353.33 / $24,073.06 / $42,669.69
| Facility | | $22,353.33 | $24,073.06 | $42,669.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $19,161.07 / $22,783.40
| Facility | | $2,651.00 | $19,161.07 | $22,783.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,304.09 / $21,021.60 / $33,087.36
| Facility | | $17,304.09 | $21,021.60 | $33,087.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,888.00 / $25,971.63
| Facility | | $1,350.00 | $5,888.00 | $25,971.63 |