- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $12,417.00 / $19,815.80
| Facility | | $4,804.00 | $12,417.00 | $19,815.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,913.09 / $13,320.75
| Facility | | $688.00 | $2,913.09 | $13,320.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,505.02 / $12,325.00 / $22,590.24
| Facility | | $7,505.02 | $12,325.00 | $22,590.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,379.90 / $26,811.31 / $26,811.31
| Facility | | $16,379.90 | $26,811.31 | $26,811.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,207.81 / $20,207.81 / $20,207.81
| Facility | | $20,207.81 | $20,207.81 | $20,207.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,689.00 / $10,926.25 / $23,137.00
| Facility | | $7,689.00 | $10,926.25 | $23,137.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,789.92 / $22,382.20
| Facility | | $3,775.00 | $9,789.92 | $22,382.20 |