- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,520.70 / $16,520.70 / $19,580.30
| Facility | | $16,520.70 | $16,520.70 | $19,580.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,682.67 / $19,008.33 / $28,435.30
| Facility | | $11,682.67 | $19,008.33 | $28,435.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,511.93 / $16,723.88 / $28,453.74
| Facility | | $13,511.93 | $16,723.88 | $28,453.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,088.90 / $19,396.66 / $31,749.54
| Facility | | $12,088.90 | $19,396.66 | $31,749.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.86 / $10,846.44 / $16,201.05
| Facility | | $171.86 | $10,846.44 | $16,201.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,756.57 / $19,163.08 / $22,521.42
| Facility | | $13,756.57 | $19,163.08 | $22,521.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,415.30 / $20,440.22 / $25,766.56
| Facility | | $12,415.30 | $20,440.22 | $25,766.56 |