- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,723.70 / $20,162.90 / $27,673.10
| Facility | | $2,723.70 | $20,162.90 | $27,673.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.00 / $4,175.00 / $24,954.80
| Facility | | $1,393.00 | $4,175.00 | $24,954.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,796.56 / $35,540.76
| Facility | | $100.00 | $15,796.56 | $35,540.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,500.00 / $17,180.45 / $45,156.64
| Facility | | $6,500.00 | $17,180.45 | $45,156.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,706.55 / $31,519.10 / $36,990.33
| Facility | | $21,706.55 | $31,519.10 | $36,990.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,692.22 / $14,724.23 / $23,059.55
| Facility | | $13,692.22 | $14,724.23 | $23,059.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,290.09 / $32,695.65
| Facility | | $5,693.00 | $14,290.09 | $32,695.65 |