- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $10,763.00 / $16,358.70
| Facility | | $4,804.00 | $10,763.00 | $16,358.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,183.87 / $13,027.42 / $25,835.60
| Facility | | $5,183.87 | $13,027.42 | $25,835.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.00 / $2,753.00 / $10,944.61
| Facility | | $690.00 | $2,753.00 | $10,944.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,997.22 / $10,052.61 / $17,446.84
| Facility | | $5,997.22 | $10,052.61 | $17,446.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,200.60 / $23,244.14 / $23,244.14
| Facility | | $14,200.60 | $23,244.14 | $23,244.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,540.00 / $11,359.57 / $17,111.36
| Facility | | $1,540.00 | $11,359.57 | $17,111.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,133.60 / $9,020.00 / $20,804.45
| Facility | | $6,133.60 | $9,020.00 | $20,804.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,500.00 / $7,709.57 / $18,402.24
| Facility | | $2,500.00 | $7,709.57 | $18,402.24 |