- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,558.00 / $21,212.30
| Facility | | $4,804.00 | $13,558.00 | $21,212.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,694.73 / $13,760.34 / $17,044.09
| Facility | | $7,694.73 | $13,760.34 | $17,044.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,990.00 / $13,721.59
| Facility | | $688.00 | $2,990.00 | $13,721.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,033.92 / $13,035.24 / $22,623.35
| Facility | | $8,033.92 | $13,035.24 | $22,623.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,884.70 / $29,274.43 / $29,274.43
| Facility | | $17,884.70 | $29,274.43 | $29,274.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,751.00 / $19,720.90 / $42,923.63
| Facility | | $4,751.00 | $19,720.90 | $42,923.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,262.23 / $11,696.25 / $22,623.35
| Facility | | $8,262.23 | $11,696.25 | $22,623.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,859.76 / $10,479.84 / $23,959.53
| Facility | | $3,859.76 | $10,479.84 | $23,959.53 |