- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,307.10 / $19,455.20 / $31,547.60
| Facility | | $12,307.10 | $19,455.20 | $31,547.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,047.88 / $17,177.98 / $39,543.64
| Facility | | $14,047.88 | $17,177.98 | $39,543.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,226.02 / $29,714.22
| Facility | | $100.00 | $15,226.02 | $29,714.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,041.99 / $20,819.21 / $35,820.76
| Facility | | $14,041.99 | $20,819.21 | $35,820.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,784.73 / $27,276.45 / $32,011.23
| Facility | | $18,784.73 | $27,276.45 | $32,011.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,349.39 / $17,295.59 / $36,133.19
| Facility | | $12,349.39 | $17,295.59 | $36,133.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,810.19 / $32,367.74
| Facility | | $5,693.00 | $15,810.19 | $32,367.74 |