- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,604.90 / $14,604.90 / $17,309.70
| Facility | | $14,604.90 | $14,604.90 | $17,309.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,534.12 / $17,139.59 / $25,639.78
| Facility | | $10,534.12 | $17,139.59 | $25,639.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,945.01 / $14,784.48 / $25,154.08
| Facility | | $11,945.01 | $14,784.48 | $25,154.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,687.00 / $17,147.31 / $28,067.68
| Facility | | $10,687.00 | $17,147.31 | $28,067.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.96 / $9,780.10 / $14,322.29
| Facility | | $154.96 | $9,780.10 | $14,322.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,161.28 / $16,940.82 / $19,909.71
| Facility | | $12,161.28 | $16,940.82 | $19,909.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,683.20 / $18,405.21 / $24,229.50
| Facility | | $10,683.20 | $18,405.21 | $24,229.50 |