- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,034.90 / $13,034.90 / $15,449.00
| Facility | | $13,034.90 | $13,034.90 | $15,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,248.28 / $15,047.45 / $22,510.07
| Facility | | $9,248.28 | $15,047.45 | $22,510.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,660.97 / $13,195.21 / $22,450.12
| Facility | | $10,660.97 | $13,195.21 | $22,450.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,538.19 / $15,304.05 / $25,050.52
| Facility | | $9,538.19 | $15,304.05 | $25,050.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.05 / $8,586.29 / $12,782.70
| Facility | | $136.05 | $8,586.29 | $12,782.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,853.99 / $15,119.75 / $17,769.50
| Facility | | $10,853.99 | $15,119.75 | $17,769.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,795.71 / $16,127.42 / $20,329.93
| Facility | | $9,795.71 | $16,127.42 | $20,329.93 |