- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,114.30 / $16,063.20 / $24,458.00
| Facility | | $11,114.30 | $16,063.20 | $24,458.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,523.39 / $15,673.75 / $20,804.66
| Facility | | $12,523.39 | $15,673.75 | $20,804.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,143.21 / $15,895.06 / $23,225.12
| Facility | | $10,143.21 | $15,895.06 | $23,225.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,591.83 / $11,733.12 / $14,321.39
| Facility | | $9,591.83 | $11,733.12 | $14,321.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.84 / $176.22 / $1,105.04
| Facility | | $118.84 | $176.22 | $1,105.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,314.19 / $17,042.36 / $28,047.74
| Facility | | $12,314.19 | $17,042.36 | $28,047.74 |