- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,322.00 / $18,440.20 / $28,420.70
| Facility | | $11,322.00 | $18,440.20 | $28,420.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,179.47 / $14,893.26 / $34,284.22
| Facility | | $12,179.47 | $14,893.26 | $34,284.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,533.95 / $27,256.99
| Facility | | $100.00 | $12,533.95 | $27,256.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,151.59 / $18,396.00 / $32,270.26
| Facility | | $12,151.59 | $18,396.00 | $32,270.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,286.30 / $23,648.60 / $27,753.64
| Facility | | $16,286.30 | $23,648.60 | $27,753.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,777.68 / $15,561.18 / $32,551.72
| Facility | | $10,777.68 | $15,561.18 | $32,551.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,243.10 / $29,159.50
| Facility | | $5,693.00 | $14,243.10 | $29,159.50 |