- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,541.40 / $18,397.09 / $27,995.00
| Facility | | $13,541.40 | $18,397.09 | $27,995.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,253.89 / $11,009.00 / $14,489.28
| Facility | | $4,253.89 | $11,009.00 | $14,489.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,809.72 / $16,793.91 / $24,472.08
| Facility | | $10,809.72 | $16,793.91 | $24,472.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,123.86 / $15,746.38 / $32,469.80
| Facility | | $11,123.86 | $15,746.38 | $32,469.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.67 / $172.96 / $293.85
| Facility | | $123.67 | $172.96 | $293.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,766.00 / $16,069.60 / $27,571.29
| Facility | | $1,766.00 | $16,069.60 | $27,571.29 |