- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $20,892.96 / $21,877.62
| Facility | | $17,782.79 | $20,892.96 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $22,387.21 / $32,359.37
| Facility | | $12,882.50 | $22,387.21 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $18,620.87 / $33,113.11
| Facility | | $13,489.63 | $18,620.87 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $17,782.79 / $22,387.21
| Facility | | $15,488.17 | $17,782.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,892.96 / $33,884.42
| Facility | | $12,882.50 | $20,892.96 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.91 / $13,489.63 / $17,378.01
| Facility | | $147.91 | $13,489.63 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $23,988.33 / $25,118.86
| Facility | | $19,498.45 | $23,988.33 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $22,387.21 / $30,199.52
| Facility | | $13,182.57 | $22,387.21 | $30,199.52 |