- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,877.00 / $11,877.00 / $14,076.60
| Facility | | $11,877.00 | $11,877.00 | $14,076.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,735.03 / $14,212.36 / $21,260.83
| Facility | | $8,735.03 | $14,212.36 | $21,260.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,713.93 / $12,023.05 / $20,455.82
| Facility | | $9,713.93 | $12,023.05 | $20,455.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,690.89 / $13,944.55 / $22,825.22
| Facility | | $8,690.89 | $13,944.55 | $22,825.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.50 / $8,109.79 / $11,647.18
| Facility | | $128.50 | $8,109.79 | $11,647.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,889.79 / $13,776.62 / $16,190.99
| Facility | | $9,889.79 | $13,776.62 | $16,190.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,925.54 / $14,694.78 / $18,523.97
| Facility | | $8,925.54 | $14,694.78 | $18,523.97 |