- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,169.60 / $15,174.90 / $21,744.00
| Facility | | $11,169.60 | $15,174.90 | $21,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,291.40 / $16,291.40 / $16,291.40
| Facility | | $16,291.40 | $16,291.40 | $16,291.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,088.54 / $14,053.11 / $20,448.03
| Facility | | $9,088.54 | $14,053.11 | $20,448.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,744.07 / $13,452.27 / $24,348.00
| Facility | | $9,744.07 | $13,452.27 | $24,348.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.57 / $142.66 / $227.37
| Facility | | $103.57 | $142.66 | $227.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,732.60 / $14,853.50 / $24,445.39
| Facility | | $10,732.60 | $14,853.50 | $24,445.39 |