- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,633.08 / $13,647.20 / $22,129.70
| Facility | | $8,633.08 | $13,647.20 | $22,129.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,662.00 / $13,662.00 / $13,662.00
| Facility | | $13,662.00 | $13,662.00 | $13,662.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,559.04 / $11,688.97 / $26,907.96
| Facility | | $9,559.04 | $11,688.97 | $26,907.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,402.35 / $20,445.59
| Facility | | $100.00 | $10,402.35 | $20,445.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,227.34 / $14,897.68 / $25,127.16
| Facility | | $10,227.34 | $14,897.68 | $25,127.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,782.30 / $18,560.59 / $21,782.44
| Facility | | $12,782.30 | $18,560.59 | $21,782.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,573.37 / $12,424.64 / $25,346.32
| Facility | | $8,573.37 | $12,424.64 | $25,346.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,090.36 / $22,704.97
| Facility | | $5,693.00 | $11,090.36 | $22,704.97 |