- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $8,750.00 / $13,608.80
| Facility | | $4,804.00 | $8,750.00 | $13,608.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,263.91 / $11,263.91 / $11,534.61
| Facility | | $11,263.91 | $11,263.91 | $11,534.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,587.00 / $8,913.95
| Facility | | $688.00 | $2,587.00 | $8,913.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,226.00 / $8,464.00 / $15,823.91
| Facility | | $5,226.00 | $8,464.00 | $15,823.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,540.60 / $18,890.14 / $18,890.14
| Facility | | $11,540.60 | $18,890.14 | $18,890.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,657.70 / $10,657.70 / $58,191.31
| Facility | | $10,657.70 | $10,657.70 | $58,191.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,300.65 / $7,503.75 / $17,307.25
| Facility | | $5,300.65 | $7,503.75 | $17,307.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,881.44 / $6,723.36 / $15,371.28
| Facility | | $2,881.44 | $6,723.36 | $15,371.28 |