- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,337.00 / $1,337.00 / $31,102.90
| Facility | | $1,337.00 | $1,337.00 | $31,102.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $24,263.40 / $45,360.53
| Facility | | $1,346.00 | $24,263.40 | $45,360.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,564.72 / $4,816.47 / $23,303.63
| Facility | | $3,564.72 | $4,816.47 | $23,303.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,202.91 / $30,811.14 / $50,433.39
| Facility | | $19,202.91 | $30,811.14 | $50,433.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,834.95 / $5,834.95 / $5,834.95
| Facility | | $5,834.95 | $5,834.95 | $5,834.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.45 / $17,959.37 / $25,700.13
| Facility | | $285.45 | $17,959.37 | $25,700.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,851.99 / $30,440.09 / $35,774.74
| Facility | | $21,851.99 | $30,440.09 | $35,774.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,721.41 / $32,468.81 / $40,929.58
| Facility | | $19,721.41 | $32,468.81 | $40,929.58 |