- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $18,197.01 / $18,620.87
| Facility | | $15,135.61 | $18,197.01 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $19,498.45 / $28,183.83
| Facility | | $11,220.18 | $19,498.45 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $15,848.93 / $28,840.32
| Facility | | $11,748.98 | $15,848.93 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $15,135.61 / $19,498.45
| Facility | | $13,182.57 | $15,135.61 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $29,512.09
| Facility | | $11,220.18 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $11,481.54 / $15,135.61
| Facility | | $128.82 | $11,481.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $20,892.96 / $21,877.62
| Facility | | $16,595.87 | $20,892.96 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,054.61 / $26,302.68
| Facility | | $11,481.54 | $19,054.61 | $26,302.68 |