- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.46 / $13,576.70 / $22,015.40
| Facility | | $8,588.46 | $13,576.70 | $22,015.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,505.83 / $11,623.88 / $26,758.13
| Facility | | $9,505.83 | $11,623.88 | $26,758.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,711.40 / $19,162.20
| Facility | | $100.00 | $9,711.40 | $19,162.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,819.10 / $14,089.96 / $24,997.35
| Facility | | $8,819.10 | $14,089.96 | $24,997.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,711.13 / $18,457.25 / $21,661.15
| Facility | | $12,711.13 | $18,457.25 | $21,661.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,527.48 / $12,108.94 / $25,215.38
| Facility | | $8,527.48 | $12,108.94 | $25,215.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,033.06 / $22,587.68
| Facility | | $5,693.00 | $11,033.06 | $22,587.68 |