- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,608.24 / $15,188.70 / $24,629.40
| Facility | | $9,608.24 | $15,188.70 | $24,629.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,637.23 / $9,637.23 / $9,637.23
| Facility | | $9,637.23 | $9,637.23 | $9,637.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,927.95 / $13,362.88 / $30,761.29
| Facility | | $10,927.95 | $13,362.88 | $30,761.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,084.49 / $21,334.73
| Facility | | $100.00 | $11,084.49 | $21,334.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,479.83 / $15,942.00 / $27,965.46
| Facility | | $10,479.83 | $15,942.00 | $27,965.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,901.77 / $24,901.77 / $24,901.77
| Facility | | $24,901.77 | $24,901.77 | $24,901.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,724.91 / $13,546.71 / $28,209.37
| Facility | | $9,724.91 | $13,546.71 | $28,209.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,343.09 / $25,269.66
| Facility | | $5,693.00 | $12,343.09 | $25,269.66 |