- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,419.00 / $9,727.29 / $18,390.00
| Facility | | $2,419.00 | $9,727.29 | $18,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,828.56 / $16,068.84 / $20,836.33
| Facility | | $10,828.56 | $16,068.84 | $20,836.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,206.78 / $14,648.00 / $20,634.34
| Facility | | $10,206.78 | $14,648.00 | $20,634.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,235.32 / $13,902.85 / $29,154.72
| Facility | | $7,235.32 | $13,902.85 | $29,154.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,423.05 / $5,542.25 / $6,324.47
| Facility | | $5,423.05 | $5,542.25 | $6,324.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,206.78 / $15,548.50 / $20,639.43
| Facility | | $10,206.78 | $15,548.50 | $20,639.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,346.00 / $13,119.37 / $18,885.09
| Facility | | $4,346.00 | $13,119.37 | $18,885.09 |