- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,882.50 / $24,547.09
| Facility | | $7,244.36 | $12,882.50 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,803.84 / $23,442.29
| Facility | | $7,943.28 | $13,803.84 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $6,456.54 / $19,952.62
| Facility | | $100.00 | $6,456.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,481.54 / $19,952.62
| Facility | | $8,128.31 | $11,481.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,589.25 / $23,442.29
| Facility | | $7,943.28 | $12,589.25 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $11,220.18 / $21,877.62
| Facility | | $5,128.61 | $11,220.18 | $21,877.62 |