- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $14,791.08 / $15,488.17
| Facility | | $12,589.25 | $14,791.08 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,848.93 / $22,908.68
| Facility | | $9,120.11 | $15,848.93 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $23,442.29
| Facility | | $9,549.93 | $13,182.57 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $12,589.25 / $15,848.93
| Facility | | $10,964.78 | $12,589.25 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,791.08 / $23,988.33
| Facility | | $9,120.11 | $14,791.08 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.71 / $9,332.54 / $12,302.69
| Facility | | $104.71 | $9,332.54 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $16,982.44 / $17,782.79
| Facility | | $13,803.84 | $16,982.44 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,848.93 / $21,379.62
| Facility | | $9,120.11 | $15,848.93 | $21,379.62 |