- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,881.10 / $17,200.90 / $27,892.30
| Facility | | $10,881.10 | $17,200.90 | $27,892.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,688.94 / $16,739.06 / $38,533.25
| Facility | | $13,688.94 | $16,739.06 | $38,533.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $13,940.46 / $26,963.46
| Facility | | $100.00 | $13,940.46 | $26,963.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,567.39 / $18,406.96 / $31,670.33
| Facility | | $12,567.39 | $18,406.96 | $31,670.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,304.75 / $26,579.50 / $31,193.30
| Facility | | $18,304.75 | $26,579.50 | $31,193.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,046.32 / $15,341.39 / $31,946.55
| Facility | | $12,046.32 | $15,341.39 | $31,946.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.00 / $15,258.34 / $31,027.60
| Facility | | $5,017.00 | $15,258.34 | $31,027.60 |