- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,308.18 / $15,160.30 / $23,365.60
| Facility | | $9,308.18 | $15,160.30 | $23,365.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,238.71 / $12,520.08 / $28,821.18
| Facility | | $10,238.71 | $12,520.08 | $28,821.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,641.79 / $21,443.96
| Facility | | $100.00 | $10,641.79 | $21,443.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,178.01 / $15,419.67 / $26,530.52
| Facility | | $10,178.01 | $15,419.67 | $26,530.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,691.15 / $19,880.30 / $23,331.22
| Facility | | $13,691.15 | $19,880.30 | $23,331.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,143.99 / $12,851.62 / $26,761.92
| Facility | | $9,143.99 | $12,851.62 | $26,761.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,709.76 / $23,973.05
| Facility | | $5,693.00 | $11,709.76 | $23,973.05 |