- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,547.00 / $17,904.80
| Facility | | $4,804.00 | $11,547.00 | $17,904.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,931.83 / $12,227.90 / $15,885.14
| Facility | | $7,931.83 | $12,227.90 | $15,885.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,867.59 / $11,962.03
| Facility | | $688.00 | $2,867.59 | $11,962.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,781.22 / $11,136.00 / $20,411.59
| Facility | | $6,781.22 | $11,136.00 | $20,411.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,230.40 / $24,929.76 / $24,929.76
| Facility | | $15,230.40 | $24,929.76 | $24,929.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,072.20 / $17,734.45 / $56,725.50
| Facility | | $4,072.20 | $17,734.45 | $56,725.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,973.93 / $9,872.50 / $22,770.72
| Facility | | $6,973.93 | $9,872.50 | $22,770.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $8,845.76 / $20,223.62
| Facility | | $3,775.00 | $8,845.76 | $20,223.62 |