- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $23,648.70 / $38,077.40
| Facility | | $1,638.00 | $23,648.70 | $38,077.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,589.84 / $13,589.84 / $13,589.84
| Facility | | $13,589.84 | $13,589.84 | $13,589.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $2,555.21 / $16,912.16
| Facility | | $1,474.01 | $2,555.21 | $16,912.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,455.15 / $22,455.15 / $22,612.45
| Facility | | $22,455.15 | $22,455.15 | $22,612.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,963.54 / $20,738.57 / $43,553.55
| Facility | | $14,963.54 | $20,738.57 | $43,553.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,049.21 / $20,738.57 / $44,115.91
| Facility | | $14,049.21 | $20,738.57 | $44,115.91 |