- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,522.80 / $22,024.70 / $33,945.40
| Facility | | $13,522.80 | $22,024.70 | $33,945.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,632.02 / $17,892.27 / $41,187.93
| Facility | | $14,632.02 | $17,892.27 | $41,187.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,196.86 / $32,384.92
| Facility | | $100.00 | $15,196.86 | $32,384.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,593.19 / $21,691.86 / $38,543.28
| Facility | | $13,593.19 | $21,691.86 | $38,543.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,565.83 / $28,410.65 / $33,342.31
| Facility | | $19,565.83 | $28,410.65 | $33,342.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,840.77 / $18,453.18 / $38,879.44
| Facility | | $12,840.77 | $18,453.18 | $38,879.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $17,011.82 / $34,827.82
| Facility | | $5,693.00 | $17,011.82 | $34,827.82 |