- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,254.00 / $17,721.09
| Facility | | $4,804.00 | $11,254.00 | $17,721.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,609.72 / $11,953.96 / $14,750.72
| Facility | | $11,609.72 | $11,953.96 | $14,750.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,753.00 / $11,266.23
| Facility | | $688.00 | $2,753.00 | $11,266.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,486.00 / $10,431.00 / $18,576.32
| Facility | | $6,486.00 | $10,431.00 | $18,576.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,846.60 / $24,301.54 / $24,301.54
| Facility | | $14,846.60 | $24,301.54 | $24,301.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,453.41 / $3,994.85 / $8,191.22
| Facility | | $3,453.41 | $3,994.85 | $8,191.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,644.45 / $9,661.81 / $18,899.93
| Facility | | $6,644.45 | $9,661.81 | $18,899.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,375.00 / $10,580.00 / $20,415.66
| Facility | | $4,375.00 | $10,580.00 | $20,415.66 |