- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $17,378.01 / $20,892.96
| Facility | | $14,454.40 | $17,378.01 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $25,118.86
| Facility | | $15,488.17 | $15,488.17 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $17,782.79 / $27,542.29
| Facility | | $13,803.84 | $17,782.79 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $23,442.29 / $23,442.29
| Facility | | $10,471.29 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $29,512.09
| Facility | | $14,454.40 | $19,952.62 | $29,512.09 |