- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,903.10 / $21,978.00 / $29,805.00
| Facility | | $13,903.10 | $21,978.00 | $29,805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,710.00 / $17,120.06 / $40,696.62
| Facility | | $9,710.00 | $17,120.06 | $40,696.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $16,498.86 / $36,344.47
| Facility | | $100.00 | $16,498.86 | $36,344.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,756.12 / $23,068.00 / $40,465.89
| Facility | | $15,756.12 | $23,068.00 | $40,465.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,128.02 / $30,679.05 / $36,004.47
| Facility | | $21,128.02 | $30,679.05 | $36,004.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,823.52 / $19,602.03 / $40,818.83
| Facility | | $13,823.52 | $19,602.03 | $40,818.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $17,860.40 / $36,565.08
| Facility | | $5,693.00 | $17,860.40 | $36,565.08 |