- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,256.00 / $16,024.90 / $29,988.60
| Facility | | $2,256.00 | $16,024.90 | $29,988.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,512.00 / $11,512.00 / $20,146.00
| Facility | | $11,512.00 | $11,512.00 | $20,146.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,421.00 / $13,452.47 / $25,950.50
| Facility | | $2,421.00 | $13,452.47 | $25,950.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,569.62 / $19,266.13 / $27,702.35
| Facility | | $15,569.62 | $19,266.13 | $27,702.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $910.00 / $12,935.46 / $26,580.17
| Facility | | $910.00 | $12,935.46 | $26,580.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $9,308.62 / $25,116.74
| Facility | | $800.00 | $9,308.62 | $25,116.74 |