- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,447.00 / $21,792.70
| Facility | | $4,804.00 | $11,447.00 | $21,792.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,517.74 / $13,844.04 / $19,702.28
| Facility | | $10,517.74 | $13,844.04 | $19,702.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $13,201.17
| Facility | | $675.00 | $2,690.00 | $13,201.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,253.71 / $13,554.00 / $23,242.31
| Facility | | $8,253.71 | $13,554.00 | $23,242.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,312.20 / $29,974.18 / $29,974.18
| Facility | | $18,312.20 | $29,974.18 | $29,974.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,558.47 / $24,286.16 / $129,781.84
| Facility | | $4,558.47 | $24,286.16 | $129,781.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,456.00 / $12,016.25 / $23,242.31
| Facility | | $8,456.00 | $12,016.25 | $23,242.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,614.24 / $12,242.16 / $24,515.07
| Facility | | $4,614.24 | $12,242.16 | $24,515.07 |