- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,125.38 / $14,791.08
| Facility | | $12,022.64 | $14,125.38 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $15,135.61 / $21,877.62
| Facility | | $8,709.64 | $15,135.61 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,589.25 / $22,387.21
| Facility | | $9,120.11 | $12,589.25 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $12,022.64 / $15,135.61
| Facility | | $10,471.29 | $12,022.64 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $14,125.38 / $22,908.68
| Facility | | $8,709.64 | $14,125.38 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $9,120.11 / $11,748.98
| Facility | | $100.00 | $9,120.11 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $16,218.10 / $16,982.44
| Facility | | $13,182.57 | $16,218.10 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $15,135.61 / $20,417.38
| Facility | | $8,709.64 | $15,135.61 | $20,417.38 |