- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,056.40 / $19,058.80 / $30,904.90
| Facility | | $12,056.40 | $19,058.80 | $30,904.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,888.20 / $16,982.72 / $39,094.15
| Facility | | $13,888.20 | $16,982.72 | $39,094.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,456.31 / $27,781.73
| Facility | | $100.00 | $14,456.31 | $27,781.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,924.78 / $20,395.08 / $35,091.01
| Facility | | $13,924.78 | $20,395.08 | $35,091.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,571.20 / $26,966.40 / $31,647.36
| Facility | | $18,571.20 | $26,966.40 | $31,647.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,215.06 / $17,272.18 / $35,397.08
| Facility | | $12,215.06 | $17,272.18 | $35,397.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,488.10 / $31,708.34
| Facility | | $5,693.00 | $15,488.10 | $31,708.34 |