- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,986.80 / $11,986.80 / $14,206.70
| Facility | | $11,986.80 | $11,986.80 | $14,206.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,725.21 / $14,196.41 / $21,236.96
| Facility | | $8,725.21 | $14,196.41 | $21,236.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,803.71 / $12,134.17 / $20,644.89
| Facility | | $9,803.71 | $12,134.17 | $20,644.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,771.21 / $14,073.44 / $23,036.19
| Facility | | $8,771.21 | $14,073.44 | $23,036.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.35 / $8,100.68 / $11,754.83
| Facility | | $128.35 | $8,100.68 | $11,754.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,981.20 / $13,903.96 / $16,340.64
| Facility | | $9,981.20 | $13,903.96 | $16,340.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,008.04 / $14,830.60 / $18,695.18
| Facility | | $9,008.04 | $14,830.60 | $18,695.18 |