- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,881.82 / $14,320.10 / $19,510.00
| Facility | | $8,881.82 | $14,320.10 | $19,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,504.86 / $12,845.52 / $29,570.33
| Facility | | $10,504.86 | $12,845.52 | $29,570.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,213.00 / $22,038.96
| Facility | | $100.00 | $12,213.00 | $22,038.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,960.34 / $15,507.00 / $26,719.45
| Facility | | $10,960.34 | $15,507.00 | $26,719.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,047.03 / $16,473.89 / $23,937.67
| Facility | | $14,047.03 | $16,473.89 | $23,937.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,369.00 / $13,097.74 / $27,812.69
| Facility | | $9,369.00 | $13,097.74 | $27,812.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.00 / $12,761.77 / $25,950.86
| Facility | | $5,017.00 | $12,761.77 | $25,950.86 |