- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,498.45 / $36,307.81
| Facility | | $10,715.19 | $19,498.45 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $20,892.96 / $35,481.34
| Facility | | $12,022.64 | $20,892.96 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,589.25 / $29,512.09
| Facility | | $100.00 | $12,589.25 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,982.44 / $30,199.52
| Facility | | $11,220.18 | $16,982.44 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,620.87 / $33,884.42
| Facility | | $11,748.98 | $18,620.87 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $16,218.10 / $33,113.11
| Facility | | $5,754.40 | $16,218.10 | $33,113.11 |