- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,826.70 / $20,276.40 / $32,879.40
| Facility | | $12,826.70 | $20,276.40 | $32,879.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,577.42 / $17,825.52 / $41,034.26
| Facility | | $14,577.42 | $17,825.52 | $41,034.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,608.18 / $31,443.50
| Facility | | $100.00 | $14,608.18 | $31,443.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,032.83 / $21,282.00 / $37,332.87
| Facility | | $14,032.83 | $21,282.00 | $37,332.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,492.83 / $28,304.65 / $33,217.91
| Facility | | $19,492.83 | $28,304.65 | $33,217.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,793.69 / $18,002.43 / $37,658.50
| Facility | | $12,793.69 | $18,002.43 | $37,658.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $16,477.59 / $33,734.10
| Facility | | $5,693.00 | $16,477.59 | $33,734.10 |