- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,891.75 / $12,475.30 / $20,229.40
| Facility | | $7,891.75 | $12,475.30 | $20,229.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,257.00 / $10,226.60 / $14,942.12
| Facility | | $7,257.00 | $10,226.60 | $14,942.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,737.84 / $11,907.60 / $27,411.24
| Facility | | $9,737.84 | $11,907.60 | $27,411.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,578.12 / $20,529.04
| Facility | | $100.00 | $10,578.12 | $20,529.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,349.12 / $13,618.41 / $23,169.83
| Facility | | $9,349.12 | $13,618.41 | $23,169.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,021.38 / $18,907.75 / $22,189.85
| Facility | | $13,021.38 | $18,907.75 | $22,189.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,722.25 / $11,533.75 / $23,209.47
| Facility | | $8,722.25 | $11,533.75 | $23,209.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $10,707.62 / $20,755.30
| Facility | | $5,693.00 | $10,707.62 | $20,755.30 |