- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $19,498.45 / $37,153.52
| Facility | | $10,964.78 | $19,498.45 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $21,379.62 / $35,481.34
| Facility | | $12,022.64 | $21,379.62 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,791.08 / $30,902.95
| Facility | | $100.00 | $14,791.08 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $17,782.79 / $33,884.42
| Facility | | $12,302.69 | $17,782.79 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $48,977.88 / $48,977.88
| Facility | | $48,977.88 | $48,977.88 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $19,498.45 / $37,153.52
| Facility | | $12,022.64 | $19,498.45 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $16,595.87 / $33,884.42
| Facility | | $5,754.40 | $16,595.87 | $33,884.42 |