- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,592.30 / $20,509.09 / $31,609.40
| Facility | | $12,592.30 | $20,509.09 | $31,609.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,005.58 / $16,005.58 / $22,540.92
| Facility | | $16,005.58 | $16,005.58 | $22,540.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,449.13 / $17,668.64 / $40,673.12
| Facility | | $14,449.13 | $17,668.64 | $40,673.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,484.28 / $33,313.33
| Facility | | $100.00 | $14,484.28 | $33,313.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,314.79 / $20,460.00 / $35,890.93
| Facility | | $13,314.79 | $20,460.00 | $35,890.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,321.27 / $28,055.55 / $32,925.57
| Facility | | $19,321.27 | $28,055.55 | $32,925.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,688.08 / $17,307.11 / $36,203.97
| Facility | | $12,688.08 | $17,307.11 | $36,203.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,841.16 / $32,431.15
| Facility | | $5,693.00 | $15,841.16 | $32,431.15 |