- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,573.30 / $13,573.30 / $16,087.00
| Facility | | $13,573.30 | $13,573.30 | $16,087.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,043.76 / $16,341.74 / $24,446.24
| Facility | | $10,043.76 | $16,341.74 | $24,446.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,101.29 / $13,740.19 / $23,377.34
| Facility | | $11,101.29 | $13,740.19 | $23,377.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,932.12 / $15,936.13 / $26,085.14
| Facility | | $9,932.12 | $15,936.13 | $26,085.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.75 / $9,324.84 / $13,322.95
| Facility | | $147.75 | $9,324.84 | $13,322.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,302.28 / $15,744.21 / $18,503.40
| Facility | | $11,302.28 | $15,744.21 | $18,503.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,200.29 / $16,793.50 / $21,169.58
| Facility | | $10,200.29 | $16,793.50 | $21,169.58 |