- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,768.30 / $18,603.40 / $30,166.40
| Facility | | $11,768.30 | $18,603.40 | $30,166.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,901.25 / $11,901.25 / $11,901.25
| Facility | | $11,901.25 | $11,901.25 | $11,901.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,545.64 / $16,563.83 / $38,129.86
| Facility | | $13,545.64 | $16,563.83 | $38,129.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,648.10 / $29,421.00
| Facility | | $100.00 | $13,648.10 | $29,421.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,529.75 / $19,907.73 / $34,252.51
| Facility | | $13,529.75 | $19,907.73 | $34,252.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,113.13 / $26,301.25 / $30,866.75
| Facility | | $18,113.13 | $26,301.25 | $30,866.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,925.76 / $16,592.22 / $34,551.26
| Facility | | $11,925.76 | $16,592.22 | $34,551.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,118.01 / $30,950.66
| Facility | | $5,693.00 | $15,118.01 | $30,950.66 |