- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,761.60 / $20,173.50 / $32,712.50
| Facility | | $12,761.60 | $20,173.50 | $32,712.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,025.08 / $18,372.91 / $42,294.37
| Facility | | $15,025.08 | $18,372.91 | $42,294.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,798.04 / $29,909.11
| Facility | | $100.00 | $14,798.04 | $29,909.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,739.22 / $21,587.95 / $37,143.43
| Facility | | $14,739.22 | $21,587.95 | $37,143.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,091.43 / $29,173.85 / $34,237.99
| Facility | | $20,091.43 | $29,173.85 | $34,237.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,170.26 / $17,992.61 / $37,467.39
| Facility | | $13,170.26 | $17,992.61 | $37,467.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $16,393.97 / $33,562.91
| Facility | | $5,693.00 | $16,393.97 | $33,562.91 |