- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $19,952.62 / $20,892.96
| Facility | | $16,982.44 | $19,952.62 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $21,379.62 / $30,902.95
| Facility | | $12,302.69 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $17,782.79 / $31,622.78
| Facility | | $12,882.50 | $17,782.79 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $16,982.44 / $21,379.62
| Facility | | $14,791.08 | $16,982.44 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $19,952.62 / $32,359.37
| Facility | | $12,302.69 | $19,952.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.25 / $12,882.50 / $16,595.87
| Facility | | $141.25 | $12,882.50 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $22,908.68 / $23,988.33
| Facility | | $18,620.87 | $22,908.68 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $21,379.62 / $28,840.32
| Facility | | $12,302.69 | $21,379.62 | $28,840.32 |