- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $17,378.01 / $33,113.11
| Facility | | $9,772.37 | $17,378.01 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,054.61 / $31,622.78
| Facility | | $10,715.19 | $19,054.61 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,589.25 / $26,915.35
| Facility | | $100.00 | $12,589.25 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,488.17 / $26,915.35
| Facility | | $10,232.93 | $15,488.17 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $26,915.35
| Facility | | $26,915.35 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,982.44 / $30,199.52
| Facility | | $10,471.29 | $16,982.44 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,791.08 / $30,199.52
| Facility | | $5,754.40 | $14,791.08 | $30,199.52 |