- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,653.00 / $14,653.00 / $17,366.70
| Facility | | $14,653.00 | $14,653.00 | $17,366.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,111.67 / $18,079.28 / $27,045.50
| Facility | | $11,111.67 | $18,079.28 | $27,045.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,984.37 / $14,833.19 / $25,236.96
| Facility | | $11,984.37 | $14,833.19 | $25,236.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,722.21 / $17,203.81 / $28,160.16
| Facility | | $10,722.21 | $17,203.81 | $28,160.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.46 / $10,316.29 / $14,739.52
| Facility | | $163.46 | $10,316.29 | $14,739.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,201.35 / $16,996.63 / $19,975.31
| Facility | | $12,201.35 | $16,996.63 | $19,975.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,011.71 / $18,129.39 / $22,853.58
| Facility | | $11,011.71 | $18,129.39 | $22,853.58 |