- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $18,620.87 / $34,673.69
| Facility | | $10,232.93 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,952.62 / $33,884.42
| Facility | | $11,481.54 | $19,952.62 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $19,054.61 / $28,183.83
| Facility | | $100.00 | $19,054.61 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,218.10 / $28,183.83
| Facility | | $10,715.19 | $16,218.10 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,840.32 / $28,840.32 / $28,840.32
| Facility | | $28,840.32 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $32,359.37
| Facility | | $11,220.18 | $17,782.79 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $15,488.17 / $31,622.78
| Facility | | $5,754.40 | $15,488.17 | $31,622.78 |