- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,006.40 / $15,006.40 / $17,785.59
| Facility | | $15,006.40 | $15,006.40 | $17,785.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,895.91 / $17,728.22 / $26,520.34
| Facility | | $10,895.91 | $17,728.22 | $26,520.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,273.40 / $15,190.93 / $25,845.61
| Facility | | $12,273.40 | $15,190.93 | $25,845.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,980.80 / $17,618.72 / $28,839.31
| Facility | | $10,980.80 | $17,618.72 | $28,839.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.28 / $10,115.99 / $14,716.03
| Facility | | $160.28 | $10,115.99 | $14,716.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,495.61 / $17,406.55 / $20,457.06
| Facility | | $12,495.61 | $17,406.55 | $20,457.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,976.90 / $18,911.20 / $24,895.61
| Facility | | $10,976.90 | $18,911.20 | $24,895.61 |