- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,501.20 / $15,501.20 / $18,371.90
| Facility | | $15,501.20 | $15,501.20 | $18,371.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,359.03 / $18,481.75 / $27,647.57
| Facility | | $11,359.03 | $18,481.75 | $27,647.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,678.05 / $15,691.77 / $26,697.72
| Facility | | $12,678.05 | $15,691.77 | $26,697.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,342.83 / $18,199.59 / $29,790.12
| Facility | | $11,342.83 | $18,199.59 | $29,790.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.10 / $10,545.96 / $15,201.21
| Facility | | $167.10 | $10,545.96 | $15,201.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,907.58 / $17,980.43 / $21,131.51
| Facility | | $12,907.58 | $17,980.43 | $21,131.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,649.09 / $19,178.75 / $24,176.38
| Facility | | $11,649.09 | $19,178.75 | $24,176.38 |