- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,723.70 / $11,406.50 / $15,941.30
| Facility | | $2,723.70 | $11,406.50 | $15,941.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,852.00 / $8,945.23 / $21,630.98
| Facility | | $5,852.00 | $8,945.23 | $21,630.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.00 / $6,102.00 / $15,573.79
| Facility | | $1,393.00 | $6,102.00 | $15,573.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $8,757.34 / $17,225.32
| Facility | | $100.00 | $8,757.34 | $17,225.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.83 / $9,896.93 / $26,012.82
| Facility | | $5,848.83 | $9,896.93 | $26,012.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,389.82 / $16,538.65 / $19,409.50
| Facility | | $11,389.82 | $16,538.65 | $19,409.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,279.24 / $8,020.70 / $15,373.03
| Facility | | $7,279.24 | $8,020.70 | $15,373.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,552.10 / $10,401.54 / $18,834.57
| Facility | | $5,552.10 | $10,401.54 | $18,834.57 |