- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.00 / $1,337.00 / $28,675.40
| Facility | | $1,337.00 | $1,337.00 | $28,675.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $22,756.47 / $42,543.33
| Facility | | $1,346.00 | $22,756.47 | $42,543.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,286.50 / $4,440.56 / $21,484.85
| Facility | | $3,286.50 | $4,440.56 | $21,484.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,704.18 / $28,406.42 / $46,497.21
| Facility | | $17,704.18 | $28,406.42 | $46,497.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,683.67 / $6,683.67 / $6,683.67
| Facility | | $6,683.67 | $6,683.67 | $6,683.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.73 / $16,843.97 / $24,103.98
| Facility | | $267.73 | $16,843.97 | $24,103.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,146.50 / $28,064.33 / $32,982.62
| Facility | | $20,146.50 | $28,064.33 | $32,982.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,182.21 / $29,934.71 / $37,735.14
| Facility | | $18,182.21 | $29,934.71 | $37,735.14 |