- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $13,803.84 / $14,454.40
| Facility | | $11,748.98 | $13,803.84 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $15,135.61 / $21,379.62
| Facility | | $8,511.38 | $15,135.61 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,302.69 / $21,877.62
| Facility | | $9,120.11 | $12,302.69 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $11,748.98 / $14,791.08
| Facility | | $10,232.93 | $11,748.98 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,803.84 / $22,387.21
| Facility | | $8,511.38 | $13,803.84 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.72 / $8,912.51 / $11,748.98
| Facility | | $97.72 | $8,912.51 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,218.10 / $16,595.87
| Facility | | $12,882.50 | $16,218.10 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,791.08 / $19,952.62
| Facility | | $8,511.38 | $14,791.08 | $19,952.62 |