- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,847.64 / $13,986.40 / $22,679.70
| Facility | | $8,847.64 | $13,986.40 | $22,679.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,345.18 / $12,650.26 / $29,120.84
| Facility | | $10,345.18 | $12,650.26 | $29,120.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,521.80 / $20,807.48
| Facility | | $100.00 | $10,521.80 | $20,807.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,635.00 / $14,966.99 / $25,751.66
| Facility | | $9,635.00 | $14,966.99 | $25,751.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,833.50 / $20,087.00 / $23,573.80
| Facility | | $13,833.50 | $20,087.00 | $23,573.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,234.70 / $12,474.33 / $25,976.26
| Facility | | $9,234.70 | $12,474.33 | $25,976.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,365.99 / $23,269.27
| Facility | | $5,693.00 | $11,365.99 | $23,269.27 |