- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,274.00 / $16,315.60
| Facility | | $4,804.00 | $10,274.00 | $16,315.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,831.75 / $11,151.11 / $11,789.41
| Facility | | $5,831.75 | $11,151.11 | $11,789.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,524.10
| Facility | | $688.00 | $2,753.00 | $10,524.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,981.43 / $9,603.68 / $17,102.95
| Facility | | $5,981.43 | $9,603.68 | $17,102.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,554.60 / $22,186.74 / $22,186.74
| Facility | | $13,554.60 | $22,186.74 | $22,186.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,540.00 / $1,540.00 / $10,719.00
| Facility | | $1,540.00 | $1,540.00 | $10,719.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,357.83 / $8,895.49 / $17,400.91
| Facility | | $6,357.83 | $8,895.49 | $17,400.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,602.24 / $18,214.16
| Facility | | $3,775.00 | $9,602.24 | $18,214.16 |