- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,022.40 / $20,854.00 / $26,034.80
| Facility | | $13,022.40 | $20,854.00 | $26,034.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,451.46 / $18,883.11 / $32,976.19
| Facility | | $13,451.46 | $18,883.11 | $32,976.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,775.64 / $27,494.79
| Facility | | $100.00 | $12,775.64 | $27,494.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,046.54 / $20,913.00 / $32,322.62
| Facility | | $13,046.54 | $20,913.00 | $32,322.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,987.20 / $26,118.40 / $30,652.16
| Facility | | $17,987.20 | $26,118.40 | $30,652.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,930.69 / $17,478.11 / $33,030.89
| Facility | | $11,930.69 | $17,478.11 | $33,030.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,601.14 / $31,939.77
| Facility | | $5,693.00 | $15,601.14 | $31,939.77 |