- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,336.80 / $17,921.20 / $29,060.30
| Facility | | $11,336.80 | $17,921.20 | $29,060.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,720.31 / $14,755.00 / $32,080.62
| Facility | | $10,720.31 | $14,755.00 | $32,080.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,024.81 / $28,840.13
| Facility | | $100.00 | $13,024.81 | $28,840.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,639.47 / $18,966.55 / $32,996.50
| Facility | | $12,639.47 | $18,966.55 | $32,996.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,654.95 / $24,183.90 / $28,381.86
| Facility | | $16,654.95 | $24,183.90 | $28,381.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,008.45 / $15,797.58 / $33,284.30
| Facility | | $11,008.45 | $15,797.58 | $33,284.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,717.00 / $15,381.88 / $30,055.56
| Facility | | $5,717.00 | $15,381.88 | $30,055.56 |