- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,332.70 / $15,332.70 / $18,172.30
| Facility | | $15,332.70 | $15,332.70 | $18,172.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,888.62 / $19,343.43 / $28,936.59
| Facility | | $11,888.62 | $19,343.43 | $28,936.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,540.29 / $15,521.27 / $26,407.64
| Facility | | $12,540.29 | $15,521.27 | $26,407.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,219.59 / $18,001.84 / $29,466.44
| Facility | | $11,219.59 | $18,001.84 | $29,466.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.89 / $11,037.65 / $15,770.14
| Facility | | $174.89 | $11,037.65 | $15,770.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,767.34 / $17,785.07 / $20,901.91
| Facility | | $12,767.34 | $17,785.07 | $20,901.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,522.52 / $18,970.37 / $23,913.70
| Facility | | $11,522.52 | $18,970.37 | $23,913.70 |