- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,292.00 / $20,815.59
| Facility | | $4,804.00 | $13,292.00 | $20,815.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,256.63 / $14,512.14 / $19,621.12
| Facility | | $13,256.63 | $14,512.14 | $19,621.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,860.00 / $13,271.30
| Facility | | $688.00 | $2,860.00 | $13,271.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,883.67 / $12,947.00 / $22,200.24
| Facility | | $7,883.67 | $12,947.00 | $22,200.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,535.09 / $28,702.19 / $28,702.19
| Facility | | $17,535.09 | $28,702.19 | $28,702.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,147.00 / $9,400.10 / $20,200.00
| Facility | | $7,147.00 | $9,400.10 | $20,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.00 / $11,477.50 / $22,200.24
| Facility | | $8,076.00 | $11,477.50 | $22,200.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $10,283.84 / $23,511.43
| Facility | | $3,800.00 | $10,283.84 | $23,511.43 |