- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,254.10 / $16,648.30 / $24,713.00
| Facility | | $12,254.10 | $16,648.30 | $24,713.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,207.65 / $14,207.65 / $14,207.65
| Facility | | $14,207.65 | $14,207.65 | $14,207.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,700.32 / $15,268.50 / $22,211.00
| Facility | | $9,700.32 | $15,268.50 | $22,211.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,690.14 / $14,758.38 / $26,712.00
| Facility | | $10,690.14 | $14,758.38 | $26,712.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $113.63 / $156.52 / $249.45
| Facility | | $113.63 | $156.52 | $249.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,774.65 / $16,295.66 / $26,818.85
| Facility | | $11,774.65 | $16,295.66 | $26,818.85 |