- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,208.00 / $16,208.00 / $19,209.59
| Facility | | $16,208.00 | $16,208.00 | $19,209.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,916.61 / $17,761.91 / $26,570.74
| Facility | | $10,916.61 | $17,761.91 | $26,570.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,256.11 / $16,407.24 / $27,915.02
| Facility | | $13,256.11 | $16,407.24 | $27,915.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,860.01 / $19,029.41 / $31,148.42
| Facility | | $11,860.01 | $19,029.41 | $31,148.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.59 / $10,135.20 / $15,894.32
| Facility | | $160.59 | $10,135.20 | $15,894.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,496.11 / $18,800.25 / $22,095.02
| Facility | | $13,496.11 | $18,800.25 | $22,095.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,180.24 / $20,053.22 / $25,278.72
| Facility | | $12,180.24 | $20,053.22 | $25,278.72 |