- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,107.00 / $15,604.20 / $31,711.90
| Facility | | $12,107.00 | $15,604.20 | $31,711.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,967.08 / $10,967.08 / $12,320.33
| Facility | | $10,967.08 | $10,967.08 | $12,320.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,012.49 / $15,057.91 / $17,215.08
| Facility | | $12,012.49 | $15,057.91 | $17,215.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,663.94 / $17,106.18 / $22,247.34
| Facility | | $9,663.94 | $17,106.18 | $22,247.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,612.14 / $12,612.14 / $14,168.38
| Facility | | $12,612.14 | $12,612.14 | $14,168.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $15,543.40 / $21,851.99
| Facility | | $1,518.00 | $15,543.40 | $21,851.99 |