- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,885.20 / $21,540.60 / $41,334.00
| Facility | | $11,885.20 | $21,540.60 | $41,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,575.23 / $15,711.54 / $20,334.20
| Facility | | $14,575.23 | $15,711.54 | $20,334.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,878.65 / $16,971.04 / $35,747.08
| Facility | | $13,878.65 | $16,971.04 | $35,747.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,446.82 / $31,505.65
| Facility | | $100.00 | $14,446.82 | $31,505.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,113.40 / $21,015.25 / $35,445.37
| Facility | | $14,113.40 | $21,015.25 | $35,445.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,558.43 / $26,947.85 / $31,625.59
| Facility | | $18,558.43 | $26,947.85 | $31,625.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,208.18 / $17,075.08 / $33,599.62
| Facility | | $12,208.18 | $17,075.08 | $33,599.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,644.50 / $30,845.47
| Facility | | $5,693.00 | $15,644.50 | $30,845.47 |