- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.00 / $8,241.00 / $16,136.60
| Facility | | $2,060.00 | $8,241.00 | $16,136.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,720.00 / $15,515.60 / $21,450.42
| Facility | | $6,720.00 | $15,515.60 | $21,450.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,753.00 / $14,969.77
| Facility | | $687.00 | $2,753.00 | $14,969.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,270.00 / $13,528.92 / $28,862.58
| Facility | | $8,270.00 | $13,528.92 | $28,862.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,377.84 / $33,021.98 / $33,021.98
| Facility | | $19,377.84 | $33,021.98 | $33,021.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,600.10 / $12,129.11 / $38,105.81
| Facility | | $5,600.10 | $12,129.11 | $38,105.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,934.40 / $12,682.10 / $32,198.46
| Facility | | $8,934.40 | $12,682.10 | $32,198.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.00 / $9,200.40 / $15,129.00
| Facility | | $3,090.00 | $9,200.40 | $15,129.00 |