- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,794.40 / $17,063.80 / $23,140.60
| Facility | | $10,794.40 | $17,063.80 | $23,140.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,198.58 / $14,916.62 / $34,338.00
| Facility | | $12,198.58 | $14,916.62 | $34,338.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,212.92 / $24,440.50
| Facility | | $100.00 | $12,212.92 | $24,440.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,769.83 / $17,910.00 / $31,417.72
| Facility | | $11,769.83 | $17,910.00 | $31,417.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,311.85 / $23,685.70 / $27,797.18
| Facility | | $16,311.85 | $23,685.70 | $27,797.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,792.62 / $15,150.07 / $31,691.75
| Facility | | $10,792.62 | $15,150.07 | $31,691.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,866.82 / $28,389.14
| Facility | | $5,693.00 | $13,866.82 | $28,389.14 |