- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,536.40 / $16,656.00 / $22,809.76
| Facility | | $10,536.40 | $16,656.00 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,765.94 / $14,387.58 / $33,120.15
| Facility | | $11,765.94 | $14,387.58 | $33,120.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,772.49 / $25,264.31
| Facility | | $100.00 | $12,772.49 | $25,264.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,907.65 / $17,823.77 / $30,666.92
| Facility | | $11,907.65 | $17,823.77 | $30,666.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,733.32 / $22,845.65 / $26,811.31
| Facility | | $15,733.32 | $22,845.65 | $26,811.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,429.84 / $14,788.02 / $30,934.40
| Facility | | $10,429.84 | $14,788.02 | $30,934.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,535.44 / $27,710.72
| Facility | | $5,693.00 | $13,535.44 | $27,710.72 |