- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,255.06 / $14,630.40 / $23,724.10
| Facility | | $9,255.06 | $14,630.40 | $23,724.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,057.87 / $10,057.87 / $10,057.87
| Facility | | $10,057.87 | $10,057.87 | $10,057.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,269.15 / $13,780.10 / $29,025.83
| Facility | | $11,269.15 | $13,780.10 | $29,025.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,375.25 / $22,909.76
| Facility | | $100.00 | $11,375.25 | $22,909.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,840.83 / $15,656.21 / $26,937.50
| Facility | | $10,840.83 | $15,656.21 | $26,937.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,069.03 / $21,881.05 / $25,679.27
| Facility | | $15,069.03 | $21,881.05 | $25,679.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,011.92 / $13,048.76 / $27,172.44
| Facility | | $10,011.92 | $13,048.76 | $27,172.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,889.38 / $24,340.80
| Facility | | $5,693.00 | $11,889.38 | $24,340.80 |