- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,446.00 / $16,490.20
| Facility | | $4,804.00 | $10,446.00 | $16,490.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,728.67
| Facility | | $688.00 | $2,753.00 | $10,728.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,245.46 / $10,256.00 / $19,174.25
| Facility | | $6,245.46 | $10,256.00 | $19,174.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,238.55 / $19,223.09 / $22,559.94
| Facility | | $13,238.55 | $19,223.09 | $22,559.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,755.09 / $14,739.38 / $24,949.06
| Facility | | $4,755.09 | $14,739.38 | $24,949.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,422.94 / $9,092.50 / $20,971.67
| Facility | | $6,422.94 | $9,092.50 | $20,971.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $9,263.44 / $19,963.49
| Facility | | $3,800.00 | $9,263.44 | $19,963.49 |