- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,635.70 / $18,393.80 / $29,826.60
| Facility | | $11,635.70 | $18,393.80 | $29,826.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,186.69 / $16,124.91 / $37,119.47
| Facility | | $13,186.69 | $16,124.91 | $37,119.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,450.29 / $30,481.16
| Facility | | $100.00 | $13,450.29 | $30,481.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,864.12 / $19,306.00 / $33,866.58
| Facility | | $12,864.12 | $19,306.00 | $33,866.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,633.15 / $25,604.30 / $30,048.82
| Facility | | $17,633.15 | $25,604.30 | $30,048.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,624.96 / $16,330.95 / $34,161.97
| Facility | | $11,624.96 | $16,330.95 | $34,161.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,045.00 / $29,471.57
| Facility | | $5,693.00 | $13,045.00 | $29,471.57 |