- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,166.00 / $14,712.80
| Facility | | $4,804.00 | $9,166.00 | $14,712.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,265.69 / $11,467.47 / $12,574.65
| Facility | | $8,265.69 | $11,467.47 | $12,574.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,690.00 / $9,498.21
| Facility | | $688.00 | $2,690.00 | $9,498.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,572.31 / $9,151.00 / $15,736.00
| Facility | | $5,572.31 | $9,151.00 | $15,736.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,091.60 / $19,792.04 / $19,792.04
| Facility | | $12,091.60 | $19,792.04 | $19,792.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,405.00 / $9,974.45 / $21,841.20
| Facility | | $1,405.00 | $9,974.45 | $21,841.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,730.67 / $8,112.50 / $15,736.00
| Facility | | $5,730.67 | $8,112.50 | $15,736.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,115.20 / $7,268.80 / $16,618.29
| Facility | | $3,115.20 | $7,268.80 | $16,618.29 |