- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,716.73 / $15,360.20 / $22,809.76
| Facility | | $9,716.73 | $15,360.20 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,109.47 / $13,584.84 / $31,272.25
| Facility | | $11,109.47 | $13,584.84 | $31,272.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,208.10 / $23,050.93
| Facility | | $100.00 | $11,208.10 | $23,050.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,719.64 / $16,122.00 / $28,281.21
| Facility | | $10,719.64 | $16,122.00 | $28,281.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,855.50 / $21,571.00 / $25,315.40
| Facility | | $14,855.50 | $21,571.00 | $25,315.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,876.45 / $13,637.60 / $28,527.88
| Facility | | $9,876.45 | $13,637.60 | $28,527.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,482.46 / $25,554.98
| Facility | | $5,693.00 | $12,482.46 | $25,554.98 |