- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,551.80 / $17,442.30
| Facility | | $4,804.00 | $11,551.80 | $17,442.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,713.00 / $11,266.33
| Facility | | $687.00 | $2,713.00 | $11,266.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.07 / $10,742.00 / $18,602.55
| Facility | | $6,606.07 | $10,742.00 | $18,602.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,243.10 / $26,587.39 / $26,587.39
| Facility | | $16,243.10 | $26,587.39 | $26,587.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,768.00 / $9,617.50 / $18,602.55
| Facility | | $6,768.00 | $9,617.50 | $18,602.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,295.34 / $8,464.17 / $19,621.24
| Facility | | $3,295.34 | $8,464.17 | $19,621.24 |