- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $17,378.01 / $33,113.11
| Facility | | $9,772.37 | $17,378.01 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $31,622.78
| Facility | | $10,715.19 | $18,620.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,302.69 / $26,915.35
| Facility | | $100.00 | $12,302.69 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,488.17 / $26,915.35
| Facility | | $10,471.29 | $15,488.17 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $26,915.35 / $26,915.35
| Facility | | $26,915.35 | $26,915.35 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,378.01 / $30,902.95
| Facility | | $10,471.29 | $17,378.01 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,791.08 / $30,199.52
| Facility | | $5,754.40 | $14,791.08 | $30,199.52 |