- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,659.08 / $15,363.20 / $21,437.40
| Facility | | $8,659.08 | $15,363.20 | $21,437.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,059.79 / $10,059.79 / $10,059.79
| Facility | | $10,059.79 | $10,059.79 | $10,059.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,658.00 / $8,192.64 / $16,487.68
| Facility | | $1,658.00 | $8,192.64 | $16,487.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,177.50 / $7,177.50 / $15,138.27
| Facility | | $7,177.50 | $7,177.50 | $15,138.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,708.00 / $3,708.00 / $3,708.00
| Facility | | $3,708.00 | $3,708.00 | $3,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,425.76 / $15,085.04 / $25,971.04
| Facility | | $7,425.76 | $15,085.04 | $25,971.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,939.89 / $14,673.80 / $21,214.70
| Facility | | $7,939.89 | $14,673.80 | $21,214.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,177.50 / $7,177.50 / $15,138.27
| Facility | | $7,177.50 | $7,177.50 | $15,138.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,714.38 / $10,654.34
| Facility | | $2,621.40 | $7,714.38 | $10,654.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,465.89 / $12,103.32 / $21,954.01
| Facility | | $4,465.89 | $12,103.32 | $21,954.01 |