- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,562.00 / $2,562.00 / $27,600.70
| Facility | | $2,562.00 | $2,562.00 | $27,600.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.00 / $25,255.94 / $39,643.19
| Facility | | $3,162.00 | $25,255.94 | $39,643.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,046.59 / $23,574.18 / $40,108.74
| Facility | | $19,046.59 | $23,574.18 | $40,108.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,522.00 / $26,405.18 / $44,754.54
| Facility | | $1,522.00 | $26,405.18 | $44,754.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,311.00 / $2,477.00 / $3,136.00
| Facility | | $1,311.00 | $2,477.00 | $3,136.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $244.70 / $15,443.60 / $22,065.19
| Facility | | $244.70 | $15,443.60 | $22,065.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,391.43 / $27,012.51 / $31,746.47
| Facility | | $19,391.43 | $27,012.51 | $31,746.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,522.00 / $26,933.25 / $36,320.86
| Facility | | $1,522.00 | $26,933.25 | $36,320.86 |