- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $14,681.00 / $22,193.90
| Facility | | $4,804.00 | $14,681.00 | $22,193.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,169.12 / $19,382.33 / $20,766.87
| Facility | | $13,169.12 | $19,382.33 | $20,766.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $14,253.74
| Facility | | $688.00 | $3,027.00 | $14,253.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,405.69 / $13,804.00 / $23,670.26
| Facility | | $8,405.69 | $13,804.00 | $23,670.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,366.70 / $31,700.23 / $31,700.23
| Facility | | $19,366.70 | $31,700.23 | $31,700.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.57 / $12,237.50 / $23,670.26
| Facility | | $8,644.57 | $12,237.50 | $23,670.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,818.10 / $10,769.98 / $24,966.46
| Facility | | $3,818.10 | $10,769.98 | $24,966.46 |