- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,677.00 / $12,677.00 / $15,024.80
| Facility | | $12,677.00 | $12,677.00 | $15,024.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,361.61 / $15,231.84 / $22,785.90
| Facility | | $9,361.61 | $15,231.84 | $22,785.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,368.25 / $12,832.90 / $21,833.70
| Facility | | $10,368.25 | $12,832.90 | $21,833.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,276.29 / $14,883.84 / $24,362.70
| Facility | | $9,276.29 | $14,883.84 | $24,362.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.71 / $8,691.51 / $12,431.72
| Facility | | $137.71 | $8,691.51 | $12,431.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,555.97 / $14,704.60 / $17,281.59
| Facility | | $10,555.97 | $14,704.60 | $17,281.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,526.76 / $15,684.61 / $19,771.72
| Facility | | $9,526.76 | $15,684.61 | $19,771.72 |