- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,812.00 / $17,118.09
| Facility | | $4,804.00 | $10,812.00 | $17,118.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,751.73 / $12,698.22 / $17,574.43
| Facility | | $7,751.73 | $12,698.22 | $17,574.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,849.23
| Facility | | $688.00 | $2,753.00 | $10,849.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,282.43 / $10,076.04 / $17,944.20
| Facility | | $6,282.43 | $10,076.04 | $17,944.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,263.30 / $23,346.77 / $23,346.77
| Facility | | $14,263.30 | $23,346.77 | $23,346.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,730.00 / $14,863.61 / $39,385.56
| Facility | | $1,730.00 | $14,863.61 | $39,385.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,440.00 / $9,333.04 / $18,256.81
| Facility | | $6,440.00 | $9,333.04 | $18,256.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,624.48 / $8,457.12 / $19,335.09
| Facility | | $3,624.48 | $8,457.12 | $19,335.09 |