- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,823.05 / $12,366.70 / $20,053.30
| Facility | | $7,823.05 | $12,366.70 | $20,053.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,685.58 / $10,620.87 / $24,449.21
| Facility | | $8,685.58 | $10,620.87 | $24,449.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,276.82 / $22,894.00
| Facility | | $100.00 | $9,276.82 | $22,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,018.94 / $13,499.85 / $22,769.52
| Facility | | $9,018.94 | $13,499.85 | $22,769.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,614.30 / $16,864.59 / $19,792.04
| Facility | | $11,614.30 | $16,864.59 | $19,792.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,838.64 / $11,069.18 / $22,968.11
| Facility | | $7,838.64 | $11,069.18 | $22,968.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,691.00 / $20,574.59
| Facility | | $5,693.00 | $10,691.00 | $20,574.59 |