- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,568.56 / $8,565.49 / $12,933.20
| Facility | | $4,568.56 | $8,565.49 | $12,933.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,546.01 / $12,546.01 / $13,690.05
| Facility | | $12,546.01 | $12,546.01 | $13,690.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,501.55 / $8,682.53
| Facility | | $688.00 | $2,501.55 | $8,682.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.02 / $8,044.00 / $14,744.00
| Facility | | $4,989.02 | $8,044.00 | $14,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,044.10 / $19,714.29 / $19,714.29
| Facility | | $12,044.10 | $19,714.29 | $19,714.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,091.71 / $7,131.25 / $14,913.00
| Facility | | $5,091.71 | $7,131.25 | $14,913.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,738.40 / $6,389.60 / $14,548.89
| Facility | | $2,738.40 | $6,389.60 | $14,548.89 |