- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,630.40 / $13,630.40 / $16,154.80
| Facility | | $13,630.40 | $13,630.40 | $16,154.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,417.18 / $15,322.26 / $22,921.17
| Facility | | $9,417.18 | $15,322.26 | $22,921.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,148.02 / $13,798.04 / $23,475.76
| Facility | | $11,148.02 | $13,798.04 | $23,475.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,973.94 / $16,003.22 / $26,194.96
| Facility | | $9,973.94 | $16,003.22 | $26,194.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.53 / $8,743.11 / $13,366.68
| Facility | | $138.53 | $8,743.11 | $13,366.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,349.86 / $15,810.50 / $18,581.30
| Facility | | $11,349.86 | $15,810.50 | $18,581.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,243.24 / $16,864.21 / $21,258.71
| Facility | | $10,243.24 | $16,864.21 | $21,258.71 |