- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,765.10 / $19,161.90 / $29,533.00
| Facility | | $11,765.10 | $19,161.90 | $29,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,602.70 / $12,602.70 / $12,602.70
| Facility | | $12,602.70 | $12,602.70 | $12,602.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,048.85 / $15,956.35 / $36,731.44
| Facility | | $13,048.85 | $15,956.35 | $36,731.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,930.09 / $29,074.77
| Facility | | $100.00 | $12,930.09 | $29,074.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,366.59 / $19,116.00 / $33,533.29
| Facility | | $12,366.59 | $19,116.00 | $33,533.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,448.83 / $25,336.65 / $29,734.71
| Facility | | $17,448.83 | $25,336.65 | $29,734.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,507.87 / $16,054.57 / $33,825.76
| Facility | | $11,507.87 | $16,054.57 | $33,825.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $15,632.11 / $30,544.50
| Facility | | $5,717.00 | $15,632.11 | $30,544.50 |