- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,696.60 / $14,696.60 / $17,418.40
| Facility | | $14,696.60 | $14,696.60 | $17,418.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,414.26 / $16,944.56 / $25,348.03
| Facility | | $10,414.26 | $16,944.56 | $25,348.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,020.04 / $14,877.34 / $25,312.07
| Facility | | $12,020.04 | $14,877.34 | $25,312.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,754.12 / $17,255.00 / $28,243.97
| Facility | | $10,754.12 | $17,255.00 | $28,243.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.19 / $9,668.82 / $14,412.24
| Facility | | $153.19 | $9,668.82 | $14,412.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,237.66 / $17,047.22 / $20,034.75
| Facility | | $12,237.66 | $17,047.22 | $20,034.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,258.71 / $18,048.78 / $22,921.59
| Facility | | $10,258.71 | $18,048.78 | $22,921.59 |