- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $12,803.00 / $19,854.40
| Facility | | $4,804.00 | $12,803.00 | $19,854.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,266.39 / $13,616.21 / $17,451.86
| Facility | | $7,266.39 | $13,616.21 | $17,451.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,973.88 / $12,951.98
| Facility | | $688.00 | $2,973.88 | $12,951.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,519.62 / $12,349.00 / $22,634.18
| Facility | | $7,519.62 | $12,349.00 | $22,634.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,889.09 / $27,644.79 / $27,644.79
| Facility | | $16,889.09 | $27,644.79 | $27,644.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.56 / $6,987.93 / $46,774.68
| Facility | | $1,758.56 | $6,987.93 | $46,774.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,733.31 / $10,947.50 / $25,250.19
| Facility | | $7,733.31 | $10,947.50 | $25,250.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,808.95 / $22,425.73
| Facility | | $3,775.00 | $9,808.95 | $22,425.73 |