- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,397.29 / $14,855.30 / $24,088.70
| Facility | | $9,397.29 | $14,855.30 | $24,088.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,918.00 / $12,119.31 / $16,451.84
| Facility | | $4,918.00 | $12,119.31 | $16,451.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,649.53 / $13,022.42 / $29,977.56
| Facility | | $10,649.53 | $13,022.42 | $29,977.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,973.22 / $23,009.68
| Facility | | $100.00 | $10,973.22 | $23,009.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,494.99 / $15,748.58 / $27,351.49
| Facility | | $10,494.99 | $15,748.58 | $27,351.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,240.48 / $20,677.95 / $24,267.33
| Facility | | $14,240.48 | $20,677.95 | $24,267.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,490.70 / $13,189.27 / $27,590.04
| Facility | | $9,490.70 | $13,189.27 | $27,590.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,072.11 / $24,714.88
| Facility | | $5,693.00 | $12,072.11 | $24,714.88 |