- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,848.93 / $30,199.52
| Facility | | $8,912.51 | $15,848.93 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $8,912.51 / $8,912.51
| Facility | | $8,912.51 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $17,378.01 / $28,840.32
| Facility | | $9,772.37 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,481.54 / $24,547.09
| Facility | | $100.00 | $11,481.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,125.38 / $24,547.09
| Facility | | $9,332.54 | $14,125.38 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,848.93 / $28,183.83
| Facility | | $9,549.93 | $15,848.93 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $13,489.63 / $27,542.29
| Facility | | $5,754.40 | $13,489.63 | $27,542.29 |