- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,728.70 / $17,473.80 / $31,564.00
| Facility | | $10,728.70 | $17,473.80 | $31,564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,486.97 / $16,302.75 / $18,236.83
| Facility | | $10,486.97 | $16,302.75 | $18,236.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,891.50 / $14,541.12 / $33,473.60
| Facility | | $11,891.50 | $14,541.12 | $33,473.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,581.26 / $24,566.94
| Facility | | $100.00 | $11,581.26 | $24,566.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,254.38 / $17,772.80 / $30,845.92
| Facility | | $11,254.38 | $17,772.80 | $30,845.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,901.22 / $23,089.45 / $27,097.43
| Facility | | $15,901.22 | $23,089.45 | $27,097.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,535.45 / $14,812.84 / $32,108.00
| Facility | | $10,535.45 | $14,812.84 | $32,108.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,496.73 / $27,631.46
| Facility | | $5,693.00 | $13,496.73 | $27,631.46 |