- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,700.30 / $16,915.09 / $27,428.80
| Facility | | $10,700.30 | $16,915.09 | $27,428.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,255.90 / $14,986.72 / $34,499.36
| Facility | | $12,255.90 | $14,986.72 | $34,499.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,971.24 / $25,662.95
| Facility | | $100.00 | $11,971.24 | $25,662.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,678.87 / $17,754.00 / $31,144.07
| Facility | | $11,678.87 | $17,754.00 | $31,144.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,388.50 / $23,797.00 / $27,927.80
| Facility | | $16,388.50 | $23,797.00 | $27,927.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,840.84 / $15,018.11 / $31,415.70
| Facility | | $10,840.84 | $15,018.11 | $31,415.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,746.03 / $28,141.87
| Facility | | $5,693.00 | $13,746.03 | $28,141.87 |