- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,041.00 / $15,041.00 / $17,826.59
| Facility | | $15,041.00 | $15,041.00 | $17,826.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,088.78 / $18,042.04 / $26,989.80
| Facility | | $11,088.78 | $18,042.04 | $26,989.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,301.69 / $15,225.94 / $25,905.18
| Facility | | $12,301.69 | $15,225.94 | $25,905.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,006.11 / $17,659.33 / $28,905.78
| Facility | | $11,006.11 | $17,659.33 | $28,905.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.12 / $10,295.06 / $14,749.95
| Facility | | $163.12 | $10,295.06 | $14,749.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,524.41 / $17,446.66 / $20,504.21
| Facility | | $12,524.41 | $17,446.66 | $20,504.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,303.28 / $18,609.41 / $23,458.69
| Facility | | $11,303.28 | $18,609.41 | $23,458.69 |