- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,054.61 / $26,915.35
| Facility | | $10,715.19 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $21,379.62 / $29,512.09
| Facility | | $12,882.50 | $21,379.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $18,197.01 / $28,183.83
| Facility | | $10,000.00 | $18,197.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $24,547.09
| Facility | | $19,952.62 | $19,952.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $19,498.45 / $24,547.09
| Facility | | $10,000.00 | $19,498.45 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $20,417.38 / $40,738.03
| Facility | | $1,905.46 | $20,417.38 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $25,703.96
| Facility | | $10,232.93 | $17,782.79 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,332.54 / $15,848.93
| Facility | | $7,943.28 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $13,803.84 / $23,988.33
| Facility | | $4,786.30 | $13,803.84 | $23,988.33 |