- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,440.90 / $12,440.90 / $14,745.00
| Facility | | $12,440.90 | $12,440.90 | $14,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,688.17 / $14,136.12 / $21,146.78
| Facility | | $8,688.17 | $14,136.12 | $21,146.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,175.15 / $12,593.91 / $21,427.07
| Facility | | $10,175.15 | $12,593.91 | $21,427.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,103.53 / $14,606.64 / $23,908.97
| Facility | | $9,103.53 | $14,606.64 | $23,908.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.81 / $8,066.28 / $12,200.19
| Facility | | $127.81 | $8,066.28 | $12,200.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,359.37 / $14,430.74 / $16,959.74
| Facility | | $10,359.37 | $14,430.74 | $16,959.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,349.33 / $15,392.50 / $19,403.49
| Facility | | $9,349.33 | $15,392.50 | $19,403.49 |