- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,576.30 / $12,576.30 / $14,905.40
| Facility | | $12,576.30 | $12,576.30 | $14,905.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,264.62 / $15,074.04 / $22,549.85
| Facility | | $9,264.62 | $15,074.04 | $22,549.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,285.85 / $12,730.91 / $21,660.17
| Facility | | $10,285.85 | $12,730.91 | $21,660.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,202.57 / $14,765.55 / $24,169.07
| Facility | | $9,202.57 | $14,765.55 | $24,169.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.29 / $8,601.46 / $12,332.92
| Facility | | $136.29 | $8,601.46 | $12,332.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,472.07 / $14,587.73 / $17,144.24
| Facility | | $10,472.07 | $14,587.73 | $17,144.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,199.29 / $15,848.72 / $20,864.00
| Facility | | $9,199.29 | $15,848.72 | $20,864.00 |