- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,503.10 / $18,184.20 / $24,660.10
| Facility | | $11,503.10 | $18,184.20 | $24,660.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,542.51 / $15,337.19 / $35,306.14
| Facility | | $12,542.51 | $15,337.19 | $35,306.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,542.03 / $25,165.29
| Facility | | $100.00 | $13,542.03 | $25,165.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,554.02 / $19,086.00 / $33,480.66
| Facility | | $12,554.02 | $19,086.00 | $33,480.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,771.75 / $24,353.50 / $28,580.90
| Facility | | $16,771.75 | $24,353.50 | $28,580.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,081.93 / $16,144.85 / $33,772.68
| Facility | | $11,081.93 | $16,144.85 | $33,772.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.00 / $16,130.53 / $32,801.19
| Facility | | $5,017.00 | $16,130.53 | $32,801.19 |