- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,854.50 / $12,854.50 / $15,235.10
| Facility | | $12,854.50 | $12,854.50 | $15,235.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,476.03 / $15,418.00 / $23,064.40
| Facility | | $9,476.03 | $15,418.00 | $23,064.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,513.38 / $13,012.53 / $22,139.32
| Facility | | $10,513.38 | $13,012.53 | $22,139.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,406.14 / $15,092.18 / $24,703.72
| Facility | | $9,406.14 | $15,092.18 | $24,703.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.40 / $8,797.74 / $12,605.74
| Facility | | $139.40 | $8,797.74 | $12,605.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,703.73 / $14,910.43 / $17,523.49
| Facility | | $10,703.73 | $14,910.43 | $17,523.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,660.11 / $15,904.15 / $20,048.48
| Facility | | $9,660.11 | $15,904.15 | $20,048.48 |