- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,240.70 / $18,307.80 / $31,564.00
| Facility | | $11,240.70 | $18,307.80 | $31,564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,643.50 / $15,460.68 / $35,590.43
| Facility | | $12,643.50 | $15,460.68 | $35,590.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,618.59 / $28,227.24
| Facility | | $100.00 | $12,618.59 | $28,227.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,158.48 / $18,621.06 / $32,318.15
| Facility | | $12,158.48 | $18,621.06 | $32,318.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,906.80 / $24,549.60 / $28,811.04
| Facility | | $16,906.80 | $24,549.60 | $28,811.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,166.88 / $15,433.99 / $33,640.46
| Facility | | $11,166.88 | $15,433.99 | $33,640.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,140.90 / $28,950.27
| Facility | | $5,693.00 | $14,140.90 | $28,950.27 |