- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,316.10 / $13,316.10 / $15,782.30
| Facility | | $13,316.10 | $13,316.10 | $15,782.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,986.01 / $16,247.77 / $24,305.67
| Facility | | $9,986.01 | $16,247.77 | $24,305.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,890.97 / $13,479.88 / $22,934.45
| Facility | | $10,890.97 | $13,479.88 | $22,934.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,743.95 / $15,634.21 / $25,590.95
| Facility | | $9,743.95 | $15,634.21 | $25,590.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.90 / $9,271.21 / $13,246.34
| Facility | | $146.90 | $9,271.21 | $13,246.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,088.15 / $15,445.94 / $18,152.84
| Facility | | $11,088.15 | $15,445.94 | $18,152.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,007.04 / $16,475.34 / $20,768.52
| Facility | | $10,007.04 | $16,475.34 | $20,768.52 |