- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,096.60 / $13,096.60 / $15,522.00
| Facility | | $13,096.60 | $13,096.60 | $15,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,598.07 / $15,616.58 / $23,361.45
| Facility | | $9,598.07 | $15,616.58 | $23,361.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,711.40 / $13,257.62 / $22,556.31
| Facility | | $10,711.40 | $13,257.62 | $22,556.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,583.31 / $15,376.44 / $25,169.01
| Facility | | $9,583.31 | $15,376.44 | $25,169.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.19 / $8,911.04 / $12,843.16
| Facility | | $141.19 | $8,911.04 | $12,843.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,905.33 / $15,191.27 / $17,853.55
| Facility | | $10,905.33 | $15,191.27 | $17,853.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,842.06 / $16,203.70 / $20,426.09
| Facility | | $9,842.06 | $16,203.70 | $20,426.09 |