- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,078.60 / $15,078.60 / $17,871.09
| Facility | | $15,078.60 | $15,078.60 | $17,871.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,725.17 / $19,077.48 / $28,538.74
| Facility | | $11,725.17 | $19,077.48 | $28,538.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,332.44 / $15,264.00 / $25,969.93
| Facility | | $12,332.44 | $15,264.00 | $25,969.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,033.62 / $17,703.47 / $28,978.03
| Facility | | $11,033.62 | $17,703.47 | $28,978.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.48 / $10,885.89 / $15,553.32
| Facility | | $172.48 | $10,885.89 | $15,553.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,555.72 / $17,490.28 / $20,555.46
| Facility | | $12,555.72 | $17,490.28 | $20,555.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,331.53 / $18,655.93 / $23,517.33
| Facility | | $11,331.53 | $18,655.93 | $23,517.33 |