- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,238.40 / $19,346.50 / $31,371.50
| Facility | | $12,238.40 | $19,346.50 | $31,371.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,490.91 / $15,047.65 / $34,386.66
| Facility | | $11,490.91 | $15,047.65 | $34,386.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,140.90 / $30,848.60
| Facility | | $100.00 | $15,140.90 | $30,848.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,215.29 / $22,780.29 / $41,780.61
| Facility | | $15,215.29 | $22,780.29 | $41,780.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,852.15 / $25,922.30 / $30,422.02
| Facility | | $17,852.15 | $25,922.30 | $30,422.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,762.74 / $17,255.02 / $38,905.86
| Facility | | $11,762.74 | $17,255.02 | $38,905.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,721.92 / $32,187.04
| Facility | | $5,693.00 | $15,721.92 | $32,187.04 |