- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $12,706.00 / $20,013.09
| Facility | | $4,804.00 | $12,706.00 | $20,013.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,226.61 / $13,334.66 / $19,793.20
| Facility | | $7,226.61 | $13,334.66 | $19,793.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $561.00 / $1,175.00 / $2,500.00
| Facility | | $561.00 | $1,175.00 | $2,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,945.20 / $18,776.27 / $26,537.85
| Facility | | $7,945.20 | $18,776.27 | $26,537.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,761.80 / $27,436.42 / $27,436.42
| Facility | | $16,761.80 | $27,436.42 | $27,436.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,330.45 / $14,490.09 / $28,353.72
| Facility | | $9,330.45 | $14,490.09 | $28,353.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,062.40 / $9,534.24 / $26,537.85
| Facility | | $7,062.40 | $9,534.24 | $26,537.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $9,887.36 / $22,341.90
| Facility | | $3,800.00 | $9,887.36 | $22,341.90 |