- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,440.50 / $18,085.09 / $29,326.00
| Facility | | $11,440.50 | $18,085.09 | $29,326.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,511.52 / $16,522.11 / $38,033.82
| Facility | | $13,511.52 | $16,522.11 | $38,033.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,626.45 / $30,042.11
| Facility | | $100.00 | $14,626.45 | $30,042.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,374.50 / $19,353.09 / $33,396.92
| Facility | | $13,374.50 | $19,353.09 | $33,396.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,067.50 / $26,235.00 / $30,789.00
| Facility | | $18,067.50 | $26,235.00 | $30,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,897.05 / $16,464.99 / $33,588.65
| Facility | | $11,897.05 | $16,464.99 | $33,588.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,696.81 / $30,088.37
| Facility | | $5,693.00 | $14,696.81 | $30,088.37 |