- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,222.80 / $19,321.80 / $31,331.30
| Facility | | $12,222.80 | $19,321.80 | $31,331.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,867.73 / $16,957.68 / $39,036.51
| Facility | | $13,867.73 | $16,957.68 | $39,036.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,922.92 / $30,786.91
| Facility | | $100.00 | $13,922.92 | $30,786.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,908.78 / $20,676.47 / $35,575.18
| Facility | | $13,908.78 | $20,676.47 | $35,575.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,543.83 / $26,926.65 / $31,600.71
| Facility | | $18,543.83 | $26,926.65 | $31,600.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,197.86 / $17,131.50 / $35,885.46
| Facility | | $12,197.86 | $17,131.50 | $35,885.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,701.79 / $32,145.83
| Facility | | $5,693.00 | $15,701.79 | $32,145.83 |