- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,456.00 / $14,456.00 / $17,133.30
| Facility | | $14,456.00 | $14,456.00 | $17,133.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,502.52 / $17,088.16 / $25,562.86
| Facility | | $10,502.52 | $17,088.16 | $25,562.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,823.25 / $14,633.77 / $24,897.67
| Facility | | $11,823.25 | $14,633.77 | $24,897.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,578.06 / $16,972.52 / $27,781.57
| Facility | | $10,578.06 | $16,972.52 | $27,781.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.50 / $9,750.76 / $14,176.29
| Facility | | $154.50 | $9,750.76 | $14,176.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,037.31 / $16,768.13 / $19,706.75
| Facility | | $12,037.31 | $16,768.13 | $19,706.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,863.67 / $17,885.66 / $22,546.33
| Facility | | $10,863.67 | $17,885.66 | $22,546.33 |