- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,980.80 / $13,980.80 / $16,570.00
| Facility | | $13,980.80 | $13,980.80 | $16,570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,668.16 / $17,357.66 / $25,966.01
| Facility | | $10,668.16 | $17,357.66 | $25,966.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,434.59 / $14,152.73 / $24,079.23
| Facility | | $11,434.59 | $14,152.73 | $24,079.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,230.34 / $16,414.59 / $26,868.33
| Facility | | $10,230.34 | $16,414.59 | $26,868.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.93 / $9,904.54 / $14,151.21
| Facility | | $156.93 | $9,904.54 | $14,151.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,641.62 / $16,216.92 / $19,058.95
| Facility | | $11,641.62 | $16,216.92 | $19,058.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,506.56 / $17,297.72 / $21,805.18
| Facility | | $10,506.56 | $17,297.72 | $21,805.18 |