- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,982.44 / $31,622.78
| Facility | | $9,549.93 | $16,982.44 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,054.61 / $26,302.68
| Facility | | $14,454.40 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,848.93 / $25,118.86
| Facility | | $100.00 | $15,848.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,848.93 / $26,302.68
| Facility | | $10,000.00 | $15,848.93 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $29,512.09
| Facility | | $10,232.93 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,454.40 / $28,183.83
| Facility | | $5,754.40 | $14,454.40 | $28,183.83 |