- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,168.20 / $14,394.30 / $29,253.00
| Facility | | $11,168.20 | $14,394.30 | $29,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,494.28 / $10,494.28 / $17,847.72
| Facility | | $10,494.28 | $10,494.28 | $17,847.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,019.91 / $13,813.69 / $15,792.62
| Facility | | $11,019.91 | $13,813.69 | $15,792.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,914.62 / $15,779.81 / $20,522.33
| Facility | | $8,914.62 | $15,779.81 | $20,522.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,068.42 / $12,068.42 / $20,524.88
| Facility | | $12,068.42 | $12,068.42 | $20,524.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $12,655.02 / $19,489.04
| Facility | | $1,286.00 | $12,655.02 | $19,489.04 |