- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,630.20 / $19,965.80 / $32,375.70
| Facility | | $12,630.20 | $19,965.80 | $32,375.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,367.24 / $17,568.50 / $40,442.62
| Facility | | $14,367.24 | $17,568.50 | $40,442.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $15,240.25 / $28,688.39
| Facility | | $100.00 | $15,240.25 | $28,688.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,506.93 / $21,365.69 / $36,761.01
| Facility | | $14,506.93 | $21,365.69 | $36,761.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,211.77 / $27,896.55 / $32,738.97
| Facility | | $19,211.77 | $27,896.55 | $32,738.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,616.90 / $17,804.73 / $37,081.64
| Facility | | $12,616.90 | $17,804.73 | $37,081.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $16,225.18 / $33,217.36
| Facility | | $5,693.00 | $16,225.18 | $33,217.36 |