- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,383.90 / $15,383.90 / $18,232.90
| Facility | | $15,383.90 | $15,383.90 | $18,232.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,536.65 / $18,770.75 / $28,079.90
| Facility | | $11,536.65 | $18,770.75 | $28,079.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,582.11 / $15,573.03 / $26,495.70
| Facility | | $12,582.11 | $15,573.03 | $26,495.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,257.00 / $18,061.88 / $29,564.70
| Facility | | $11,257.00 | $18,061.88 | $29,564.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.71 / $10,710.87 / $15,303.25
| Facility | | $169.71 | $10,710.87 | $15,303.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,809.91 / $17,844.37 / $20,971.61
| Facility | | $12,809.91 | $17,844.37 | $20,971.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,560.94 / $19,033.63 / $23,993.44
| Facility | | $11,560.94 | $19,033.63 | $23,993.44 |