- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,966.70 / $17,336.20 / $28,111.70
| Facility | | $10,966.70 | $17,336.20 | $28,111.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,837.30 / $15,697.67 / $36,135.97
| Facility | | $12,837.30 | $15,697.67 | $36,135.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,563.70 / $25,415.00
| Facility | | $100.00 | $12,563.70 | $25,415.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,943.48 / $18,196.00 / $31,919.42
| Facility | | $11,943.48 | $18,196.00 | $31,919.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,252.66 / $29,252.66 / $29,252.66
| Facility | | $29,252.66 | $29,252.66 | $29,252.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,329.91 / $15,373.03 / $32,197.82
| Facility | | $11,329.91 | $15,373.03 | $32,197.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,088.25 / $28,842.48
| Facility | | $5,693.00 | $14,088.25 | $28,842.48 |