- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,132.90 / $16,503.50 / $25,435.80
| Facility | | $10,132.90 | $16,503.50 | $25,435.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,700.43 / $14,307.47 / $32,935.75
| Facility | | $11,700.43 | $14,307.47 | $32,935.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,830.34 / $25,299.30
| Facility | | $100.00 | $11,830.34 | $25,299.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,649.70 / $16,785.87 / $28,881.15
| Facility | | $11,649.70 | $16,785.87 | $28,881.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,645.72 / $22,718.45 / $26,662.03
| Facility | | $15,645.72 | $22,718.45 | $26,662.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,361.11 / $13,912.90 / $29,133.05
| Facility | | $10,361.11 | $13,912.90 | $29,133.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,747.25 / $26,097.09
| Facility | | $5,693.00 | $12,747.25 | $26,097.09 |