- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,782.00 / $11,139.00 / $24,805.20
| Facility | | $1,782.00 | $11,139.00 | $24,805.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,691.00 / $13,635.00 / $20,505.00
| Facility | | $8,691.00 | $13,635.00 | $20,505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,009.46 / $18,290.89 / $42,722.05
| Facility | | $6,009.46 | $18,290.89 | $42,722.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,472.00 / $17,044.28 / $37,356.23
| Facility | | $11,472.00 | $17,044.28 | $37,356.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,736.00 / $7,957.00 / $10,400.00
| Facility | | $5,736.00 | $7,957.00 | $10,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $259.02 / $16,348.06 / $23,357.45
| Facility | | $259.02 | $16,348.06 | $23,357.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,522.57 / $12,979.25 / $27,598.26
| Facility | | $11,522.57 | $12,979.25 | $27,598.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,385.00 / $15,090.00 / $34,294.75
| Facility | | $11,385.00 | $15,090.00 | $34,294.75 |