- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,261.09 / $14,640.00 / $23,739.50
| Facility | | $9,261.09 | $14,640.00 | $23,739.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,627.69 / $12,995.72 / $29,916.09
| Facility | | $10,627.69 | $12,995.72 | $29,916.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,684.00 / $11,210.29 / $22,044.44
| Facility | | $1,684.00 | $11,210.29 | $22,044.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,545.99 / $15,666.41 / $26,955.04
| Facility | | $10,545.99 | $15,666.41 | $26,955.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,211.28 / $20,635.55 / $24,217.57
| Facility | | $14,211.28 | $20,635.55 | $24,217.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,475.78 / $12,998.10 / $27,190.14
| Facility | | $9,475.78 | $12,998.10 | $27,190.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,897.13 / $24,356.65
| Facility | | $5,693.00 | $11,897.13 | $24,356.65 |