- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,152.30 / $14,152.30 / $16,773.20
| Facility | | $14,152.30 | $14,152.30 | $16,773.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,870.50 / $16,059.83 / $24,024.53
| Facility | | $9,870.50 | $16,059.83 | $24,024.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,574.81 / $14,326.27 / $24,374.49
| Facility | | $11,574.81 | $14,326.27 | $24,374.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,355.78 / $16,615.87 / $27,197.79
| Facility | | $10,355.78 | $16,615.87 | $27,197.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.19 / $9,163.98 / $13,878.40
| Facility | | $145.19 | $9,163.98 | $13,878.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,784.37 / $16,415.78 / $19,292.65
| Facility | | $11,784.37 | $16,415.78 | $19,292.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,635.39 / $17,509.82 / $22,072.56
| Facility | | $10,635.39 | $17,509.82 | $22,072.56 |