- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,071.10 / $14,071.10 / $16,677.00
| Facility | | $14,071.10 | $14,071.10 | $16,677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,257.34 / $16,689.24 / $24,966.09
| Facility | | $10,257.34 | $16,689.24 | $24,966.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,508.39 / $14,244.07 / $24,234.63
| Facility | | $11,508.39 | $14,244.07 | $24,234.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,296.36 / $16,520.53 / $27,041.73
| Facility | | $10,296.36 | $16,520.53 | $27,041.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.88 / $9,523.12 / $13,798.77
| Facility | | $150.88 | $9,523.12 | $13,798.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,716.75 / $16,321.58 / $19,181.95
| Facility | | $11,716.75 | $16,321.58 | $19,181.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,574.36 / $17,409.34 / $21,945.91
| Facility | | $10,574.36 | $17,409.34 | $21,945.91 |