- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,654.00 / $15,445.10
| Facility | | $4,804.00 | $9,654.00 | $15,445.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,517.82 / $8,585.41 / $15,468.51
| Facility | | $4,517.82 | $8,585.41 | $15,468.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $10,160.15
| Facility | | $688.00 | $2,753.00 | $10,160.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,849.64 / $9,606.00 / $17,959.07
| Facility | | $5,849.64 | $9,606.00 | $17,959.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,735.70 / $20,846.33 / $20,846.33
| Facility | | $12,735.70 | $20,846.33 | $20,846.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,643.14 / $15,653.00 / $43,037.63
| Facility | | $9,643.14 | $15,653.00 | $43,037.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,015.88 / $8,516.25 / $19,642.56
| Facility | | $6,015.88 | $8,516.25 | $19,642.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,270.24 / $7,630.56 / $17,374.50
| Facility | | $3,270.24 | $7,630.56 | $17,374.50 |