- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,485.20 / $20,962.20 / $27,901.00
| Facility | | $10,485.20 | $20,962.20 | $27,901.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,151.78 / $18,484.00 / $28,134.00
| Facility | | $11,151.78 | $18,484.00 | $28,134.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,564.03 / $23,650.85
| Facility | | $100.00 | $11,564.03 | $23,650.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,293.53 / $19,817.62 / $28,157.00
| Facility | | $11,293.53 | $19,817.62 | $28,157.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,912.08 / $21,653.15 / $25,411.81
| Facility | | $14,912.08 | $21,653.15 | $25,411.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,940.62 / $15,370.62 / $28,657.00
| Facility | | $9,940.62 | $15,370.62 | $28,657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,301.00 / $16,301.00 / $16,301.00
| Facility | | $16,301.00 | $16,301.00 | $16,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $14,427.19 / $24,619.00
| Facility | | $5,717.00 | $14,427.19 | $24,619.00 |