- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,995.10 / $17,442.80 / $34,098.00
| Facility | | $10,995.10 | $17,442.80 | $34,098.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,288.50 / $10,288.50 / $14,750.69
| Facility | | $10,288.50 | $10,288.50 | $14,750.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,466.00 / $14,716.09 / $25,569.20
| Facility | | $7,466.00 | $14,716.09 | $25,569.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,328.00 / $17,793.84 / $26,723.84
| Facility | | $12,328.00 | $17,793.84 | $26,723.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,336.87 / $18,261.43 / $81,276.00
| Facility | | $9,336.87 | $18,261.43 | $81,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,257.53 / $25,641.30
| Facility | | $9,226.00 | $17,257.53 | $25,641.30 |