- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,331.50 / $16,332.00 / $26,483.30
| Facility | | $10,331.50 | $16,332.00 | $26,483.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,220.00 / $6,220.00 / $6,220.00
| Facility | | $6,220.00 | $6,220.00 | $6,220.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,073.02 / $14,763.08 / $33,984.56
| Facility | | $12,073.02 | $14,763.08 | $33,984.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $11,650.70 / $24,275.73
| Facility | | $100.00 | $11,650.70 | $24,275.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,805.09 / $17,066.90 / $30,070.50
| Facility | | $10,805.09 | $17,066.90 | $30,070.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,143.95 / $23,441.90 / $27,511.06
| Facility | | $16,143.95 | $23,441.90 | $27,511.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,685.83 / $14,500.42 / $30,332.77
| Facility | | $10,685.83 | $14,500.42 | $30,332.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $13,272.19 / $27,171.78
| Facility | | $5,693.00 | $13,272.19 | $27,171.78 |