- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,053.10 / $19,631.00 / $30,256.00
| Facility | | $12,053.10 | $19,631.00 | $30,256.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,575.26 / $15,377.24 / $32,389.97
| Facility | | $12,575.26 | $15,377.24 | $32,389.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,756.80 / $29,109.51
| Facility | | $100.00 | $13,756.80 | $29,109.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,267.45 / $19,979.91 / $36,071.76
| Facility | | $13,267.45 | $19,979.91 | $36,071.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,815.55 / $24,417.10 / $28,655.54
| Facility | | $16,815.55 | $24,417.10 | $28,655.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,109.47 / $16,447.62 / $36,071.76
| Facility | | $11,109.47 | $16,447.62 | $36,071.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,162.91 / $31,042.60
| Facility | | $5,693.00 | $15,162.91 | $31,042.60 |