- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.00 / $27,609.60 / $46,255.90
| Facility | | $4,002.00 | $27,609.60 | $46,255.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,812.00 / $5,812.00 / $6,916.00
| Facility | | $5,812.00 | $5,812.00 | $6,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,669.40 / $31,783.16 / $37,241.66
| Facility | | $20,669.40 | $31,783.16 | $37,241.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $24,604.10 / $36,869.67
| Facility | | $2,400.00 | $24,604.10 | $36,869.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,034.00 / $30,792.08 / $47,011.13
| Facility | | $3,034.00 | $30,792.08 | $47,011.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,388.00 / $24,618.57
| Facility | | $1,500.00 | $2,388.00 | $24,618.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $31,540.88 / $45,435.34
| Facility | | $3,775.00 | $31,540.88 | $45,435.34 |