- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,698.17 / $13,750.10 / $22,296.50
| Facility | | $8,698.17 | $13,750.10 | $22,296.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,200.51 / $12,473.35 / $28,713.61
| Facility | | $10,200.51 | $12,473.35 | $28,713.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $10,630.02 / $21,384.95
| Facility | | $100.00 | $10,630.02 | $21,384.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,861.02 / $14,797.26 / $25,316.61
| Facility | | $9,861.02 | $14,797.26 | $25,316.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,640.05 / $19,806.09 / $23,244.14
| Facility | | $13,640.05 | $19,806.09 | $23,244.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,111.85 / $12,263.59 / $25,537.42
| Facility | | $9,111.85 | $12,263.59 | $25,537.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,846.00 / $10,661.00 / $22,031.17
| Facility | | $4,846.00 | $10,661.00 | $22,031.17 |