- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,782.30 / $13,782.30 / $16,334.80
| Facility | | $13,782.30 | $13,782.30 | $16,334.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,173.43 / $16,552.72 / $24,761.87
| Facility | | $10,173.43 | $16,552.72 | $24,761.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,272.24 / $13,951.79 / $23,737.35
| Facility | | $11,272.24 | $13,951.79 | $23,737.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,085.08 / $16,181.54 / $26,486.85
| Facility | | $10,085.08 | $16,181.54 | $26,486.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.66 / $9,445.23 / $13,515.63
| Facility | | $149.66 | $9,445.23 | $13,515.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,476.33 / $15,986.67 / $18,788.34
| Facility | | $11,476.33 | $15,986.67 | $18,788.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,357.37 / $17,052.12 / $21,495.59
| Facility | | $10,357.37 | $17,052.12 | $21,495.59 |