- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,856.09 / $16,856.09 / $19,977.80
| Facility | | $16,856.09 | $16,856.09 | $19,977.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,635.07 / $20,557.93 / $30,753.41
| Facility | | $12,635.07 | $20,557.93 | $30,753.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,786.21 / $17,063.34 / $29,031.31
| Facility | | $13,786.21 | $17,063.34 | $29,031.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,334.28 / $19,790.39 / $32,394.01
| Facility | | $12,334.28 | $19,790.39 | $32,394.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.87 / $11,730.66 / $16,760.29
| Facility | | $185.87 | $11,730.66 | $16,760.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,035.81 / $19,552.06 / $22,978.57
| Facility | | $14,035.81 | $19,552.06 | $22,978.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,667.31 / $20,855.13 / $26,289.59
| Facility | | $12,667.31 | $20,855.13 | $26,289.59 |