- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.79 / $16,381.60 / $26,563.60
| Facility | | $10,362.79 | $16,381.60 | $26,563.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.73 / $14,755.00 / $33,578.14
| Facility | | $11,220.73 | $14,755.00 | $33,578.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,120.42 / $29,049.07
| Facility | | $100.00 | $13,120.42 | $29,049.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,480.26 / $19,289.09 / $35,377.51
| Facility | | $12,480.26 | $19,289.09 | $35,377.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,432.40 / $25,312.80 / $29,706.72
| Facility | | $17,432.40 | $25,312.80 | $29,706.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,497.52 / $14,610.60 / $31,669.63
| Facility | | $11,497.52 | $14,610.60 | $31,669.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,312.45 / $27,254.21
| Facility | | $5,693.00 | $13,312.45 | $27,254.21 |