- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,520.25 / $15,049.60 / $24,403.80
| Facility | | $9,520.25 | $15,049.60 | $24,403.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,735.85 / $12,686.49 / $22,330.23
| Facility | | $11,735.85 | $12,686.49 | $22,330.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,940.23 / $13,377.90 / $30,795.86
| Facility | | $10,940.23 | $13,377.90 | $30,795.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,018.54 / $22,526.94
| Facility | | $100.00 | $12,018.54 | $22,526.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,278.34 / $16,104.81 / $27,709.34
| Facility | | $11,278.34 | $16,104.81 | $27,709.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,629.20 / $21,242.40 / $24,929.76
| Facility | | $14,629.20 | $21,242.40 | $24,929.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,736.37 / $13,642.61 / $27,951.02
| Facility | | $9,736.37 | $13,642.61 | $27,951.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,230.05 / $25,038.24
| Facility | | $5,693.00 | $12,230.05 | $25,038.24 |