- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $11,443.00 / $18,147.30
| Facility | | $4,804.00 | $11,443.00 | $18,147.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,861.58 / $12,209.42 / $23,389.70
| Facility | | $7,861.58 | $12,209.42 | $23,389.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,771.00 / $11,496.38
| Facility | | $688.00 | $2,771.00 | $11,496.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,873.09 / $10,806.75 / $19,354.49
| Facility | | $6,873.09 | $10,806.75 | $19,354.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,095.50 / $24,708.95 / $24,708.95
| Facility | | $15,095.50 | $24,708.95 | $24,708.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,600.00 / $7,576.00 / $29,046.81
| Facility | | $3,600.00 | $7,576.00 | $29,046.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,041.00 / $9,894.18 / $19,354.49
| Facility | | $7,041.00 | $9,894.18 | $19,354.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $8,965.60 / $20,497.59
| Facility | | $3,775.00 | $8,965.60 | $20,497.59 |