- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.00 / $25,941.30 / $59,664.90
| Facility | | $4,002.00 | $25,941.30 | $59,664.90 |
- 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
- $17,131.54 / $38,902.28 / $46,430.40
| Facility | | $17,131.54 | $38,902.28 | $46,430.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $20,969.12 / $39,657.74
| Facility | | $2,400.00 | $20,969.12 | $39,657.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,034.00 / $30,917.25 / $46,246.75
| Facility | | $3,034.00 | $30,917.25 | $46,246.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,388.00 / $20,815.14
| Facility | | $1,500.00 | $2,388.00 | $20,815.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $40,684.18 / $58,606.47
| Facility | | $3,775.00 | $40,684.18 | $58,606.47 |