- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,373.30 / $14,373.30 / $17,035.20
| Facility | | $14,373.30 | $14,373.30 | $17,035.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,418.62 / $16,951.65 / $25,358.64
| Facility | | $10,418.62 | $16,951.65 | $25,358.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,755.60 / $14,550.05 / $24,755.22
| Facility | | $11,755.60 | $14,550.05 | $24,755.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,517.54 / $16,875.41 / $27,622.62
| Facility | | $10,517.54 | $16,875.41 | $27,622.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.26 / $9,672.86 / $14,095.18
| Facility | | $153.26 | $9,672.86 | $14,095.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,968.44 / $16,672.18 / $19,594.00
| Facility | | $11,968.44 | $16,672.18 | $19,594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,801.51 / $17,783.33 / $22,417.33
| Facility | | $10,801.51 | $17,783.33 | $22,417.33 |