- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,774.80 / $13,774.80 / $16,325.90
| Facility | | $13,774.80 | $13,774.80 | $16,325.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,065.54 / $16,377.20 / $24,499.29
| Facility | | $10,065.54 | $16,377.20 | $24,499.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,266.09 / $13,944.18 / $23,724.40
| Facility | | $11,266.09 | $13,944.18 | $23,724.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,079.58 / $16,172.71 / $26,472.40
| Facility | | $10,079.58 | $16,172.71 | $26,472.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.07 / $9,345.07 / $13,508.25
| Facility | | $148.07 | $9,345.07 | $13,508.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,470.07 / $15,977.95 / $18,778.09
| Facility | | $11,470.07 | $15,977.95 | $18,778.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,351.73 / $17,042.82 / $21,483.86
| Facility | | $10,351.73 | $17,042.82 | $21,483.86 |