- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,012.10 / $15,827.10 / $22,809.76
| Facility | | $10,012.10 | $15,827.10 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,143.59 / $13,626.56 / $31,368.29
| Facility | | $11,143.59 | $13,626.56 | $31,368.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,008.71 / $20,835.90
| Facility | | $100.00 | $11,008.71 | $20,835.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,912.59 / $16,612.00 / $29,140.77
| Facility | | $10,912.59 | $16,612.00 | $29,140.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,901.13 / $21,637.25 / $25,393.15
| Facility | | $14,901.13 | $21,637.25 | $25,393.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,906.31 / $14,052.09 / $29,394.93
| Facility | | $9,906.31 | $14,052.09 | $29,394.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.00 / $14,039.63 / $28,549.38
| Facility | | $5,017.00 | $14,039.63 | $28,549.38 |