- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,477.10 / $13,477.10 / $15,973.00
| Facility | | $13,477.10 | $13,477.10 | $15,973.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,994.71 / $16,261.95 / $24,326.89
| Facility | | $9,994.71 | $16,261.95 | $24,326.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,022.57 / $13,642.76 / $23,211.58
| Facility | | $11,022.57 | $13,642.76 | $23,211.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,861.70 / $15,823.13 / $25,900.18
| Facility | | $9,861.70 | $15,823.13 | $25,900.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.03 / $9,279.31 / $13,257.91
| Facility | | $147.03 | $9,279.31 | $13,257.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,222.14 / $15,632.58 / $18,372.20
| Facility | | $11,222.14 | $15,632.58 | $18,372.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,127.96 / $16,674.43 / $21,019.47
| Facility | | $10,127.96 | $16,674.43 | $21,019.47 |