- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,682.00 / $15,056.50 / $30,598.90
| Facility | | $11,682.00 | $15,056.50 | $30,598.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,458.17 / $17,814.04 / $20,734.82
| Facility | | $11,458.17 | $17,814.04 | $20,734.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,848.48 / $14,852.32 / $16,980.04
| Facility | | $11,848.48 | $14,852.32 | $16,980.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,324.74 / $16,505.78 / $21,466.47
| Facility | | $9,324.74 | $16,505.78 | $21,466.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,176.90 / $20,063.20 / $23,845.04
| Facility | | $13,176.90 | $20,063.20 | $23,845.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $13,237.22 / $20,385.65
| Facility | | $1,286.00 | $13,237.22 | $20,385.65 |