- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.00 / $1,337.00 / $24,895.20
| Facility | | $1,337.00 | $1,337.00 | $24,895.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $19,205.80 / $35,905.33
| Facility | | $1,346.00 | $19,205.80 | $35,905.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,853.24 / $3,855.17 / $18,652.52
| Facility | | $2,853.24 | $3,855.17 | $18,652.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,370.26 / $24,661.62 / $40,367.51
| Facility | | $15,370.26 | $24,661.62 | $40,367.51 |
- 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
- $225.96 / $14,215.82 / $20,343.05
| Facility | | $225.96 | $14,215.82 | $20,343.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,490.59 / $24,364.63 / $28,634.55
| Facility | | $17,490.59 | $24,364.63 | $28,634.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,785.26 / $25,988.44 / $32,760.55
| Facility | | $15,785.26 | $25,988.44 | $32,760.55 |