- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $15,135.61 / $28,840.32
| Facility | | $8,511.38 | $15,135.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,218.10 / $27,542.29
| Facility | | $9,332.54 | $16,218.10 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,022.64 / $25,703.96
| Facility | | $100.00 | $12,022.64 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,882.50 / $23,442.29
| Facility | | $8,511.38 | $12,882.50 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,803.84 / $26,302.68
| Facility | | $9,120.11 | $13,803.84 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,882.50 / $26,302.68
| Facility | | $5,754.40 | $12,882.50 | $26,302.68 |