- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,139.79 / $16,029.10 / $25,992.00
| Facility | | $10,139.79 | $16,029.10 | $25,992.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,179.61 / $14,576.01 / $16,956.72
| Facility | | $11,179.61 | $14,576.01 | $16,956.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,740.00 / $14,355.87 / $33,047.16
| Facility | | $11,740.00 | $14,355.87 | $33,047.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,702.86 / $26,453.93
| Facility | | $100.00 | $12,702.86 | $26,453.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,676.11 / $17,152.91 / $29,512.66
| Facility | | $11,676.11 | $17,152.91 | $29,512.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,698.65 / $22,795.30 / $26,752.22
| Facility | | $15,698.65 | $22,795.30 | $26,752.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,408.02 / $14,296.19 / $29,770.07
| Facility | | $10,408.02 | $14,296.19 | $29,770.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,025.98 / $25,682.68
| Facility | | $5,693.00 | $13,025.98 | $25,682.68 |