- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,060.00 / $5,471.00 / $15,285.80
| Facility | | $2,060.00 | $5,471.00 | $15,285.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,038.00 / $14,155.21 / $17,337.16
| Facility | | $8,038.00 | $14,155.21 | $17,337.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,742.00 / $13,859.18
| Facility | | $687.00 | $2,742.00 | $13,859.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,226.00 / $12,410.80 / $27,890.84
| Facility | | $5,226.00 | $12,410.80 | $27,890.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,213.50 / $31,037.80 / $31,037.80
| Facility | | $18,213.50 | $31,037.80 | $31,037.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,434.48 / $10,321.35 / $13,305.92
| Facility | | $6,434.48 | $10,321.35 | $13,305.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.00 / $12,206.00 / $31,114.42
| Facility | | $6,548.00 | $12,206.00 | $31,114.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $6,729.00 / $13,274.16
| Facility | | $2,100.00 | $6,729.00 | $13,274.16 |