- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,570.20 / $11,570.20 / $13,713.00
| Facility | | $11,570.20 | $11,570.20 | $13,713.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,315.84 / $15,157.37 / $22,674.51
| Facility | | $9,315.84 | $15,157.37 | $22,674.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,463.03 / $11,712.50 / $19,927.46
| Facility | | $9,463.03 | $11,712.50 | $19,927.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,466.41 / $13,584.37 / $22,235.66
| Facility | | $8,466.41 | $13,584.37 | $22,235.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $137.04 / $8,649.02 / $12,357.37
| Facility | | $137.04 | $8,649.02 | $12,357.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,634.36 / $13,420.78 / $15,772.78
| Facility | | $9,634.36 | $13,420.78 | $15,772.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,695.00 / $14,315.23 / $18,045.50
| Facility | | $8,695.00 | $14,315.23 | $18,045.50 |