- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,259.20 / $18,337.90 / $28,263.10
| Facility | | $11,259.20 | $18,337.90 | $28,263.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,019.10 / $16,019.10 / $16,019.10
| Facility | | $16,019.10 | $16,019.10 | $16,019.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,064.83 / $14,753.07 / $33,961.51
| Facility | | $12,064.83 | $14,753.07 | $33,961.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,090.58 / $27,964.40
| Facility | | $100.00 | $12,090.58 | $27,964.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,565.85 / $18,268.54 / $32,091.33
| Facility | | $11,565.85 | $18,268.54 | $32,091.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,133.00 / $23,426.00 / $27,492.40
| Facility | | $16,133.00 | $23,426.00 | $27,492.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,681.25 / $15,373.03 / $32,371.23
| Facility | | $10,681.25 | $15,373.03 | $32,371.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $14,959.92 / $28,997.82
| Facility | | $5,717.00 | $14,959.92 | $28,997.82 |