- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,212.39 / $12,982.20 / $21,051.30
| Facility | | $8,212.39 | $12,982.20 | $21,051.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,148.25 / $11,186.63 / $25,751.58
| Facility | | $9,148.25 | $11,186.63 | $25,751.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,976.59 / $25,441.19
| Facility | | $100.00 | $9,976.59 | $25,441.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,622.70 / $14,171.72 / $23,902.73
| Facility | | $9,622.70 | $14,171.72 | $23,902.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,232.98 / $17,762.95 / $20,846.33
| Facility | | $12,232.98 | $17,762.95 | $20,846.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,227.82 / $11,819.19 / $24,111.21
| Facility | | $8,227.82 | $11,819.19 | $24,111.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,991.00 / $21,598.57
| Facility | | $5,693.00 | $10,991.00 | $21,598.57 |