- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,556.90 / $16,688.40 / $27,061.10
| Facility | | $10,556.90 | $16,688.40 | $27,061.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,541.13 / $27,741.84 / $38,034.00
| Facility | | $10,541.13 | $27,741.84 | $38,034.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,131.70 / $14,834.85 / $34,149.76
| Facility | | $12,131.70 | $14,834.85 | $34,149.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,707.63 / $38,721.00
| Facility | | $100.00 | $12,707.63 | $38,721.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,322.62 / $17,858.43 / $30,726.57
| Facility | | $12,322.62 | $17,858.43 | $30,726.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,644.79 / $27,644.79 / $27,644.79
| Facility | | $27,644.79 | $27,644.79 | $27,644.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,737.52 / $14,884.22 / $30,994.56
| Facility | | $10,737.52 | $14,884.22 | $30,994.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,561.76 / $27,764.61
| Facility | | $5,693.00 | $13,561.76 | $27,764.61 |