- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,469.20 / $18,700.00 / $26,583.00
| Facility | | $10,469.20 | $18,700.00 | $26,583.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,671.00 / $21,753.45 / $30,852.45
| Facility | | $9,671.00 | $21,753.45 | $30,852.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,906.45 / $16,765.82 / $25,447.26
| Facility | | $9,906.45 | $16,765.82 | $25,447.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,847.54 / $18,847.54 / $22,886.29
| Facility | | $18,847.54 | $18,847.54 | $22,886.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,314.79 / $18,700.00 / $26,440.00
| Facility | | $10,314.79 | $18,700.00 | $26,440.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,319.20 / $15,464.18 / $23,847.09
| Facility | | $9,319.20 | $15,464.18 | $23,847.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,023.53 / $12,533.80
| Facility | | $2,621.40 | $9,023.53 | $12,533.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $14,417.60 / $26,151.84
| Facility | | $5,404.00 | $14,417.60 | $26,151.84 |