- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $12,051.00 / $19,305.80
| Facility | | $4,804.00 | $12,051.00 | $19,305.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,765.00 / $12,531.16
| Facility | | $687.00 | $2,765.00 | $12,531.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,447.24 / $12,750.16 / $23,170.33
| Facility | | $7,447.24 | $12,750.16 | $23,170.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,899.20 / $26,024.48 / $26,024.48
| Facility | | $15,899.20 | $26,024.48 | $26,024.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,519.63 / $10,789.77 / $25,342.76
| Facility | | $7,519.63 | $10,789.77 | $25,342.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,537.92 / $21,806.07
| Facility | | $3,775.00 | $9,537.92 | $21,806.07 |