- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,012.40 / $12,012.40 / $14,237.00
| Facility | | $12,012.40 | $12,012.40 | $14,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,718.68 / $14,185.77 / $21,221.05
| Facility | | $8,718.68 | $14,185.77 | $21,221.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,824.62 / $12,160.05 / $20,688.91
| Facility | | $9,824.62 | $12,160.05 | $20,688.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,789.92 / $14,103.45 / $23,085.32
| Facility | | $8,789.92 | $14,103.45 | $23,085.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.26 / $8,094.61 / $11,779.90
| Facility | | $128.26 | $8,094.61 | $11,779.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,002.50 / $13,933.61 / $16,375.49
| Facility | | $10,002.50 | $13,933.61 | $16,375.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,027.25 / $14,862.23 / $18,735.06
| Facility | | $9,027.25 | $14,862.23 | $18,735.06 |