- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,640.00 / $17,329.50 / $26,708.90
| Facility | | $10,640.00 | $17,329.50 | $26,708.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,030.71 / $14,711.35 / $33,865.46
| Facility | | $12,030.71 | $14,711.35 | $33,865.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,319.24 / $27,887.86
| Facility | | $100.00 | $12,319.24 | $27,887.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,343.63 / $17,625.98 / $30,326.61
| Facility | | $12,343.63 | $17,625.98 | $30,326.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,087.38 / $23,359.75 / $27,414.65
| Facility | | $16,087.38 | $23,359.75 | $27,414.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,653.70 / $14,690.48 / $30,591.12
| Facility | | $10,653.70 | $14,690.48 | $30,591.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,385.23 / $27,403.21
| Facility | | $5,693.00 | $13,385.23 | $27,403.21 |