- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,619.82 / $13,626.20 / $22,095.70
| Facility | | $8,619.82 | $13,626.20 | $22,095.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,241.06 / $11,300.12 / $26,012.82
| Facility | | $9,241.06 | $11,300.12 | $26,012.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,829.81 / $23,672.00
| Facility | | $100.00 | $9,829.81 | $23,672.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,895.48 / $14,848.96 / $25,088.57
| Facility | | $9,895.48 | $14,848.96 | $25,088.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,357.08 / $17,943.15 / $21,057.81
| Facility | | $12,357.08 | $17,943.15 | $21,057.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,303.59 / $12,153.12 / $25,307.39
| Facility | | $8,303.59 | $12,153.12 | $25,307.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,073.32 / $22,670.10
| Facility | | $5,693.00 | $11,073.32 | $22,670.10 |