- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,314.70 / $16,314.70 / $19,336.20
| Facility | | $16,314.70 | $16,314.70 | $19,336.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,753.50 / $19,123.57 / $28,607.70
| Facility | | $11,753.50 | $19,123.57 | $28,607.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,343.43 / $16,515.32 / $28,098.91
| Facility | | $13,343.43 | $16,515.32 | $28,098.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,938.14 / $19,154.78 / $31,353.61
| Facility | | $11,938.14 | $19,154.78 | $31,353.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.90 / $10,912.20 / $15,999.02
| Facility | | $172.90 | $10,912.20 | $15,999.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,585.02 / $18,924.11 / $22,240.57
| Facility | | $13,585.02 | $18,924.11 | $22,240.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,260.48 / $20,185.32 / $25,445.24
| Facility | | $12,260.48 | $20,185.32 | $25,445.24 |