- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,723.70 / $17,715.30 / $24,313.80
| Facility | | $2,723.70 | $17,715.30 | $24,313.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.00 / $4,175.00 / $19,178.73
| Facility | | $1,393.00 | $4,175.00 | $19,178.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,188.01 / $23,737.75
| Facility | | $100.00 | $12,188.01 | $23,737.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,500.00 / $15,094.86 / $39,674.93
| Facility | | $6,500.00 | $15,094.86 | $39,674.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,682.33 / $24,223.65 / $28,428.51
| Facility | | $16,682.33 | $24,223.65 | $28,428.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,569.70 / $11,468.11 / $23,059.55
| Facility | | $10,569.70 | $11,468.11 | $23,059.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,555.37 / $28,726.62
| Facility | | $5,693.00 | $12,555.37 | $28,726.62 |