- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,702.00 / $23,309.70 / $46,363.70
| Facility | | $3,702.00 | $23,309.70 | $46,363.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,204.00 / $3,438.00 / $45,122.12
| Facility | | $2,204.00 | $3,438.00 | $45,122.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,502.34 / $50,680.35 / $72,081.94
| Facility | | $18,502.34 | $50,680.35 | $72,081.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,969.00 / $32,470.88 / $59,619.40
| Facility | | $3,969.00 | $32,470.88 | $59,619.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,787.15 / $6,787.15 / $15,505.42
| Facility | | $6,787.15 | $6,787.15 | $15,505.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,998.00 / $2,759.40 / $56,311.50
| Facility | | $1,998.00 | $2,759.40 | $56,311.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $32,268.10 / $54,094.44
| Facility | | $5,281.00 | $32,268.10 | $54,094.44 |