- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,636.70 / $21,556.90 / $34,955.69
| Facility | | $13,636.70 | $21,556.90 | $34,955.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,724.82 / $18,005.75 / $41,449.18
| Facility | | $14,724.82 | $18,005.75 | $41,449.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,686.73 / $32,321.30
| Facility | | $100.00 | $15,686.73 | $32,321.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,003.09 / $22,513.34 / $39,690.53
| Facility | | $15,003.09 | $22,513.34 | $39,690.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,689.93 / $28,590.85 / $33,553.79
| Facility | | $19,689.93 | $28,590.85 | $33,553.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,918.84 / $19,139.33 / $40,036.71
| Facility | | $12,918.84 | $19,139.33 | $40,036.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $17,518.18 / $35,864.47
| Facility | | $5,693.00 | $17,518.18 | $35,864.47 |