- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,854.00 / $24,343.00
| Facility | | $4,804.00 | $13,854.00 | $24,343.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,072.55 / $7,632.32 / $18,322.20
| Facility | | $7,072.55 | $7,632.32 | $18,322.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.00 / $1,187.00 / $2,495.00
| Facility | | $577.00 | $1,187.00 | $2,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,664.20 / $22,838.65 / $32,279.50
| Facility | | $9,664.20 | $22,838.65 | $32,279.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,278.00 / $29,918.20 / $29,918.20
| Facility | | $18,278.00 | $29,918.20 | $29,918.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,590.40 / $11,597.04 / $32,279.50
| Facility | | $8,590.40 | $11,597.04 | $32,279.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,154.24 / $13,534.18 / $29,363.06
| Facility | | $5,154.24 | $13,534.18 | $29,363.06 |