- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,723.70 / $16,323.00 / $22,812.40
| Facility | | $2,723.70 | $16,323.00 | $22,812.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,179.91 / $14,291.68 / $24,930.92
| Facility | | $11,179.91 | $14,291.68 | $24,930.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.00 / $6,574.00 / $22,014.41
| Facility | | $1,393.00 | $6,574.00 | $22,014.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,616.57 / $22,938.61
| Facility | | $100.00 | $12,616.57 | $22,938.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,500.00 / $14,162.76 / $37,225.03
| Facility | | $6,500.00 | $14,162.76 | $37,225.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,100.15 / $23,378.30 / $27,436.42
| Facility | | $16,100.15 | $23,378.30 | $27,436.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,207.73 / $11,090.66 / $23,059.55
| Facility | | $10,207.73 | $11,090.66 | $23,059.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,780.08 / $26,952.77
| Facility | | $5,693.00 | $11,780.08 | $26,952.77 |