- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,444.00 / $14,444.00 / $17,119.00
| Facility | | $14,444.00 | $14,444.00 | $17,119.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,406.62 / $16,932.15 / $25,329.46
| Facility | | $10,406.62 | $16,932.15 | $25,329.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,813.41 / $14,621.60 / $24,876.95
| Facility | | $11,813.41 | $14,621.60 | $24,876.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,569.26 / $16,958.40 / $27,758.45
| Facility | | $10,569.26 | $16,958.40 | $27,758.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.09 / $9,661.74 / $14,164.49
| Facility | | $153.09 | $9,661.74 | $14,164.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,027.29 / $16,754.16 / $19,690.36
| Facility | | $12,027.29 | $16,754.16 | $19,690.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,854.63 / $17,870.77 / $22,527.57
| Facility | | $10,854.63 | $17,870.77 | $22,527.57 |