- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.18 / $12,766.90 / $20,702.20
| Facility | | $8,076.18 | $12,766.90 | $20,702.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,031.00 / $8,565.69 / $10,983.31
| Facility | | $8,031.00 | $8,565.69 | $10,983.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,507.19 / $11,625.55 / $26,761.97
| Facility | | $9,507.19 | $11,625.55 | $26,761.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,885.17 / $19,301.00
| Facility | | $100.00 | $9,885.17 | $19,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,527.95 / $13,936.67 / $23,506.28
| Facility | | $9,527.95 | $13,936.67 | $23,506.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,712.95 / $18,459.90 / $21,664.26
| Facility | | $12,712.95 | $18,459.90 | $21,664.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,526.32 / $11,623.16 / $23,711.30
| Facility | | $8,526.32 | $11,623.16 | $23,711.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,957.85 / $21,240.34
| Facility | | $5,693.00 | $10,957.85 | $21,240.34 |