- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $13,143.00 / $21,321.10
| Facility | | $4,804.00 | $13,143.00 | $21,321.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $2,690.00 / $12,576.19
| Facility | | $675.00 | $2,690.00 | $12,576.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,463.56 / $14,391.53 / $27,988.34
| Facility | | $8,463.56 | $14,391.53 | $27,988.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,339.40 / $28,381.86 / $28,381.86
| Facility | | $17,339.40 | $28,381.86 | $28,381.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,622.19 / $2,622.19 / $2,622.19
| Facility | | $2,622.19 | $2,622.19 | $2,622.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,393.95 / $11,916.14 / $28,272.37
| Facility | | $8,393.95 | $11,916.14 | $28,272.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,514.39 / $12,170.07 / $25,717.97
| Facility | | $4,514.39 | $12,170.07 | $25,717.97 |