- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,998.80 / $12,998.80 / $15,406.20
| Facility | | $12,998.80 | $12,998.80 | $15,406.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,605.70 / $15,628.99 / $23,380.02
| Facility | | $9,605.70 | $15,628.99 | $23,380.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,631.45 / $13,158.67 / $22,387.96
| Facility | | $10,631.45 | $13,158.67 | $22,387.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,511.78 / $15,261.67 / $24,981.16
| Facility | | $9,511.78 | $15,261.67 | $24,981.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.30 / $8,918.14 / $12,747.31
| Facility | | $141.30 | $8,918.14 | $12,747.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,823.94 / $15,077.88 / $17,720.30
| Facility | | $10,823.94 | $15,077.88 | $17,720.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,768.60 / $16,082.77 / $20,273.64
| Facility | | $9,768.60 | $16,082.77 | $20,273.64 |