- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,268.10 / $15,268.10 / $18,095.70
| Facility | | $15,268.10 | $15,268.10 | $18,095.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,659.44 / $17,343.48 / $25,944.79
| Facility | | $10,659.44 | $17,343.48 | $25,944.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,487.41 / $15,455.81 / $26,296.27
| Facility | | $12,487.41 | $15,455.81 | $26,296.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,172.27 / $17,925.93 / $29,342.17
| Facility | | $11,172.27 | $17,925.93 | $29,342.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.81 / $9,896.45 / $14,972.63
| Facility | | $156.81 | $9,896.45 | $14,972.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,713.50 / $17,710.06 / $20,813.75
| Facility | | $12,713.50 | $17,710.06 | $20,813.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,473.93 / $18,890.37 / $23,812.85
| Facility | | $11,473.93 | $18,890.37 | $23,812.85 |