- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,100.29 / $12,805.00 / $20,764.00
| Facility | | $8,100.29 | $12,805.00 | $20,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,282.96 / $10,128.54 / $23,315.88
| Facility | | $8,282.96 | $10,128.54 | $23,315.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $8,530.70 / $19,480.23
| Facility | | $100.00 | $8,530.70 | $19,480.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,704.70 / $13,702.75 / $23,576.45
| Facility | | $8,704.70 | $13,702.75 | $23,576.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,075.93 / $16,082.85 / $18,874.59
| Facility | | $11,075.93 | $16,082.85 | $18,874.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,499.95 / $11,357.47 / $23,782.08
| Facility | | $7,499.95 | $11,357.47 | $23,782.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,990.56 / $21,303.74
| Facility | | $5,693.00 | $10,990.56 | $21,303.74 |