- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,334.80 / $15,905.80 / $24,390.00
| Facility | | $11,334.80 | $15,905.80 | $24,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,787.46 / $12,985.91 / $16,752.21
| Facility | | $12,787.46 | $12,985.91 | $16,752.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,222.98 / $14,260.96 / $20,750.47
| Facility | | $9,222.98 | $14,260.96 | $20,750.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,888.14 / $13,651.17 / $24,708.00
| Facility | | $9,888.14 | $13,651.17 | $24,708.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.11 / $144.78 / $230.74
| Facility | | $105.11 | $144.78 | $230.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,891.29 / $15,073.12 / $24,806.83
| Facility | | $10,891.29 | $15,073.12 | $24,806.83 |