- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $15,405.00 / $24,930.20
| Facility | | $4,804.00 | $15,405.00 | $24,930.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,030.00 / $15,486.54
| Facility | | $688.00 | $3,030.00 | $15,486.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,442.02 / $15,506.00 / $28,988.09
| Facility | | $9,442.02 | $15,506.00 | $28,988.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,322.40 / $33,264.56 / $33,264.56
| Facility | | $20,322.40 | $33,264.56 | $33,264.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,022.41 / $23,022.41 / $23,022.41
| Facility | | $23,022.41 | $23,022.41 | $23,022.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,673.00 / $13,746.25 / $31,705.45
| Facility | | $9,673.00 | $13,746.25 | $31,705.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,432.00 / $12,316.64 / $28,158.92
| Facility | | $4,432.00 | $12,316.64 | $28,158.92 |