- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,925.70 / $17,271.50 / $28,006.60
| Facility | | $10,925.70 | $17,271.50 | $28,006.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,794.60 / $14,422.63 / $33,200.83
| Facility | | $11,794.60 | $14,422.63 | $33,200.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,581.26 / $23,084.24
| Facility | | $100.00 | $11,581.26 | $23,084.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,385.31 / $17,983.37 / $31,800.14
| Facility | | $11,385.31 | $17,983.37 | $31,800.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,771.65 / $22,901.30 / $26,876.62
| Facility | | $15,771.65 | $22,901.30 | $26,876.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,455.07 / $15,334.48 / $32,077.50
| Facility | | $10,455.07 | $15,334.48 | $32,077.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $14,035.60 / $28,734.69
| Facility | | $5,693.00 | $14,035.60 | $28,734.69 |