- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $15,488.17 / $29,512.09
| Facility | | $8,709.64 | $15,488.17 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,595.87 / $28,183.83
| Facility | | $9,549.93 | $16,595.87 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,232.93 / $23,988.33
| Facility | | $100.00 | $10,232.93 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,803.84 / $23,988.33
| Facility | | $9,120.11 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $23,988.33
| Facility | | $23,988.33 | $23,988.33 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $26,915.35
| Facility | | $9,332.54 | $14,791.08 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $13,182.57 / $26,915.35
| Facility | | $5,754.40 | $13,182.57 | $26,915.35 |