- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,079.60 / $15,933.80 / $22,809.76
| Facility | | $10,079.60 | $15,933.80 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,184.12 / $12,453.33 / $28,667.51
| Facility | | $10,184.12 | $12,453.33 | $28,667.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,385.31 / $23,745.31
| Facility | | $100.00 | $11,385.31 | $23,745.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,164.80 / $16,753.68 / $29,337.24
| Facility | | $11,164.80 | $16,753.68 | $29,337.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,618.15 / $19,774.30 / $23,206.82
| Facility | | $13,618.15 | $19,774.30 | $23,206.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,099.20 / $14,146.83 / $29,593.12
| Facility | | $9,099.20 | $14,146.83 | $29,593.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,948.56 / $26,509.21
| Facility | | $5,693.00 | $12,948.56 | $26,509.21 |