- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,660.70 / $18,660.70 / $22,116.60
| Facility | | $18,660.70 | $18,660.70 | $22,116.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,333.56 / $21,694.42 / $32,453.54
| Facility | | $13,333.56 | $21,694.42 | $32,453.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,262.11 / $18,890.09 / $32,139.31
| Facility | | $15,262.11 | $18,890.09 | $32,139.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,654.75 / $21,909.08 / $35,862.01
| Facility | | $13,654.75 | $21,909.08 | $35,862.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.14 / $12,379.16 / $18,299.55
| Facility | | $196.14 | $12,379.16 | $18,299.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,538.44 / $21,645.24 / $25,438.59
| Facility | | $15,538.44 | $21,645.24 | $25,438.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,025.73 / $22,916.94 / $29,104.07
| Facility | | $13,025.73 | $22,916.94 | $29,104.07 |