- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,682.50 / $13,725.30 / $22,256.40
| Facility | | $8,682.50 | $13,725.30 | $22,256.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,164.62 / $11,206.66 / $23,605.23
| Facility | | $9,164.62 | $11,206.66 | $23,605.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $7,627.08 / $17,952.91
| Facility | | $100.00 | $7,627.08 | $17,952.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,936.82 / $14,911.00 / $25,271.01
| Facility | | $9,936.82 | $14,911.00 | $25,271.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,254.88 / $17,794.75 / $20,883.65
| Facility | | $12,254.88 | $17,794.75 | $20,883.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,241.59 / $12,241.50 / $25,491.42
| Facility | | $8,241.59 | $12,241.50 | $25,491.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,153.85 / $22,834.95
| Facility | | $5,693.00 | $11,153.85 | $22,834.95 |