- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,425.00 / $17,952.70 / $21,677.50
| Facility | | $9,425.00 | $17,952.70 | $21,677.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,211.00 / $26,570.59
| Facility | | $6,916.00 | $16,211.00 | $26,570.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,510.78 / $15,481.41 / $19,157.56
| Facility | | $13,510.78 | $15,481.41 | $19,157.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,300.00 / $12,222.00 / $59,999.40
| Facility | | $6,300.00 | $12,222.00 | $59,999.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,589.96 / $15,702.12 / $25,014.45
| Facility | | $8,589.96 | $15,702.12 | $25,014.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,076.12 / $13,965.48 / $17,282.41
| Facility | | $10,076.12 | $13,965.48 | $17,282.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,572.00 / $20,223.79
| Facility | | $3,775.00 | $13,572.00 | $20,223.79 |