- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,803.84 / $14,125.38
| Facility | | $11,481.54 | $13,803.84 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,791.08 / $21,379.62
| Facility | | $8,511.38 | $14,791.08 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,022.64 / $21,379.62
| Facility | | $8,912.51 | $12,022.64 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,481.54 / $14,791.08
| Facility | | $10,000.00 | $11,481.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,489.63 / $22,387.21
| Facility | | $8,511.38 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $8,709.64 / $11,481.54
| Facility | | $97.72 | $8,709.64 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,848.93 / $16,218.10
| Facility | | $12,589.25 | $15,848.93 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,454.40 / $19,952.62
| Facility | | $8,511.38 | $14,454.40 | $19,952.62 |