- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,745.40 / $18,567.20 / $25,179.50
| Facility | | $11,745.40 | $18,567.20 | $25,179.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,916.86 / $16,863.79 / $35,845.51
| Facility | | $13,916.86 | $16,863.79 | $35,845.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,636.63 / $27,808.68
| Facility | | $100.00 | $14,636.63 | $27,808.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,465.21 / $19,868.99 / $34,185.85
| Facility | | $13,465.21 | $19,868.99 | $34,185.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,609.53 / $27,022.05 / $31,712.67
| Facility | | $18,609.53 | $27,022.05 | $31,712.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,238.02 / $16,559.93 / $34,484.01
| Facility | | $12,238.02 | $16,559.93 | $34,484.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,088.58 / $30,890.43
| Facility | | $5,693.00 | $15,088.58 | $30,890.43 |