- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,505.00 / $28,021.80 / $47,501.60
| Facility | | $4,505.00 | $28,021.80 | $47,501.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,385.00 / $6,600.00 / $29,587.25
| Facility | | $2,385.00 | $6,600.00 | $29,587.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,468.05 / $22,087.37 / $37,001.50
| Facility | | $16,468.05 | $22,087.37 | $37,001.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,559.93 / $18,582.30 / $24,646.74
| Facility | | $12,559.93 | $18,582.30 | $24,646.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $20,056.52 / $29,096.90
| Facility | | $6,600.00 | $20,056.52 | $29,096.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,351.00 / $4,115.32 / $5,732.00
| Facility | | $2,351.00 | $4,115.32 | $5,732.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,880.80 / $11,098.36 / $25,710.11
| Facility | | $6,880.80 | $11,098.36 | $25,710.11 |