- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,734.81 / $15,388.80 / $22,809.76
| Facility | | $9,734.81 | $15,388.80 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,067.16 / $13,410.66 / $28,505.56
| Facility | | $11,067.16 | $13,410.66 | $28,505.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,929.99 / $24,113.68
| Facility | | $100.00 | $10,929.99 | $24,113.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,453.65 / $16,152.00 / $28,333.84
| Facility | | $10,453.65 | $16,152.00 | $28,333.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,798.93 / $39,000.00 / $39,000.00
| Facility | | $14,798.93 | $39,000.00 | $39,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,842.02 / $13,662.98 / $28,580.96
| Facility | | $9,842.02 | $13,662.98 | $28,580.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,505.69 / $25,602.54
| Facility | | $5,693.00 | $12,505.69 | $25,602.54 |