- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.32 / $16,052.40 / $21,141.00
| Facility | | $8,029.32 | $16,052.40 | $21,141.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,551.83 / $14,052.00 / $21,370.00
| Facility | | $8,551.83 | $14,052.00 | $21,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $8,836.20 / $17,112.00
| Facility | | $100.00 | $8,836.20 | $17,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,648.35 / $15,366.00 / $21,767.00
| Facility | | $8,648.35 | $15,366.00 | $21,767.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,435.45 / $16,604.90 / $19,487.25
| Facility | | $11,435.45 | $16,604.90 | $19,487.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,726.13 / $12,142.60 / $21,984.27
| Facility | | $7,726.13 | $12,142.60 | $21,984.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,350.00 / $12,350.00 / $12,350.00
| Facility | | $12,350.00 | $12,350.00 | $12,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,474.04 / $19,693.28
| Facility | | $5,693.00 | $10,474.04 | $19,693.28 |