- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,059.79 / $14,321.70 / $23,223.50
| Facility | | $9,059.79 | $14,321.70 | $23,223.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,154.36 / $12,168.46 / $12,865.45
| Facility | | $12,154.36 | $12,168.46 | $12,865.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,201.87 / $12,475.02 / $28,717.45
| Facility | | $10,201.87 | $12,475.02 | $28,717.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,234.93 / $22,197.73
| Facility | | $100.00 | $10,234.93 | $22,197.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,067.75 / $15,325.88 / $26,369.13
| Facility | | $10,067.75 | $15,325.88 | $26,369.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,641.88 / $19,808.75 / $23,247.25
| Facility | | $13,641.88 | $19,808.75 | $23,247.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,114.12 / $12,773.44 / $26,599.12
| Facility | | $9,114.12 | $12,773.44 | $26,599.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,638.53 / $23,827.22
| Facility | | $5,693.00 | $11,638.53 | $23,827.22 |