- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,963.80 / $15,032.16 / $27,516.60
| Facility | | $11,963.80 | $15,032.16 | $27,516.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $20,577.65 / $35,321.78
| Facility | | $12,397.00 | $20,577.65 | $35,321.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,611.62 / $19,584.90 / $23,104.26
| Facility | | $16,611.62 | $19,584.90 | $23,104.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,300.00 / $14,067.50 / $59,999.40
| Facility | | $6,300.00 | $14,067.50 | $59,999.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $20,533.91 / $29,729.56
| Facility | | $12,397.00 | $20,533.91 | $29,729.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,482.19 / $16,150.83 / $22,981.30
| Facility | | $13,482.19 | $16,150.83 | $22,981.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,040.00 / $25,671.34
| Facility | | $3,775.00 | $14,040.00 | $25,671.34 |