- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,447.44 / $13,353.70 / $21,653.80
| Facility | | $8,447.44 | $13,353.70 | $21,653.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,526.29 / $11,648.92 / $26,815.76
| Facility | | $9,526.29 | $11,648.92 | $26,815.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,206.28 / $20,896.25
| Facility | | $100.00 | $10,206.28 | $20,896.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,007.42 / $14,577.34 / $24,586.87
| Facility | | $10,007.42 | $14,577.34 | $24,586.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,738.50 / $18,497.00 / $21,707.80
| Facility | | $12,738.50 | $18,497.00 | $21,707.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,544.68 / $12,157.48 / $24,801.31
| Facility | | $8,544.68 | $12,157.48 | $24,801.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,991.00 / $22,216.76
| Facility | | $5,693.00 | $10,991.00 | $22,216.76 |