- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,295.00 / $12,866.00 / $29,250.60
| Facility | | $2,295.00 | $12,866.00 | $29,250.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,485.24 / $20,485.24 / $20,485.24
| Facility | | $20,485.24 | $20,485.24 | $20,485.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,027.00 / $12,507.00 / $27,187.51
| Facility | | $3,027.00 | $12,507.00 | $27,187.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,949.01 / $20,752.36 / $33,448.56
| Facility | | $13,949.01 | $20,752.36 | $33,448.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,996.92 / $19,724.00 / $29,692.65
| Facility | | $10,996.92 | $19,724.00 | $29,692.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.00 / $13,508.00 / $32,810.19
| Facility | | $7,264.00 | $13,508.00 | $32,810.19 |