- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,302.75 / $18,015.00 / $24,674.60
| Facility | | $7,302.75 | $18,015.00 | $24,674.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,411.38 / $15,411.38 / $16,612.74
| Facility | | $15,411.38 | $15,411.38 | $16,612.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,821.56 / $18,527.09 / $25,474.67
| Facility | | $9,821.56 | $18,527.09 | $25,474.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,774.23 / $16,907.24 / $24,088.00
| Facility | | $9,774.23 | $16,907.24 | $24,088.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,402.63 / $18,402.63 / $22,346.05
| Facility | | $18,402.63 | $18,402.63 | $22,346.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,362.20 / $14,625.72 / $21,440.09
| Facility | | $8,362.20 | $14,625.72 | $21,440.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,930.00 / $17,066.90 / $24,674.60
| Facility | | $6,930.00 | $17,066.90 | $24,674.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,196.85 / $15,099.14 / $23,284.16
| Facility | | $9,196.85 | $15,099.14 | $23,284.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,520.17 / $11,801.35
| Facility | | $2,621.40 | $8,520.17 | $11,801.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,700.00 / $15,000.00 / $27,664.00
| Facility | | $5,700.00 | $15,000.00 | $27,664.00 |