- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,747.80 / $14,747.80 / $17,479.00
| Facility | | $14,747.80 | $14,747.80 | $17,479.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,743.35 / $17,480.00 / $26,149.02
| Facility | | $10,743.35 | $17,480.00 | $26,149.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,061.85 / $14,929.10 / $25,400.13
| Facility | | $12,061.85 | $14,929.10 | $25,400.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,791.53 / $17,315.04 / $28,342.23
| Facility | | $10,791.53 | $17,315.04 | $28,342.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.04 / $9,974.35 / $14,462.38
| Facility | | $158.04 | $9,974.35 | $14,462.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,280.24 / $17,106.53 / $20,104.46
| Facility | | $12,280.24 | $17,106.53 | $20,104.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,082.91 / $18,246.61 / $23,001.34
| Facility | | $11,082.91 | $18,246.61 | $23,001.34 |