- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,729.50 / $20,455.00 / $23,844.00
| Facility | | $10,729.50 | $20,455.00 | $23,844.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,390.62 / $16,581.83 / $27,924.04
| Facility | | $11,390.62 | $16,581.83 | $27,924.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,343.55 / $21,746.22
| Facility | | $100.00 | $11,343.55 | $21,746.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,379.76 / $20,279.34 / $26,631.27
| Facility | | $11,379.76 | $20,279.34 | $26,631.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,231.45 / $22,116.90 / $25,956.06
| Facility | | $15,231.45 | $22,116.90 | $25,956.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,147.42 / $15,373.03 / $27,214.83
| Facility | | $10,147.42 | $15,373.03 | $27,214.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,932.00 / $13,932.00 / $13,932.00
| Facility | | $13,932.00 | $13,932.00 | $13,932.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $12,854.10 / $26,315.83
| Facility | | $5,693.00 | $12,854.10 | $26,315.83 |