- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,120.80 / $19,120.80 / $22,661.90
| Facility | | $19,120.80 | $19,120.80 | $22,661.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,564.58 / $22,070.30 / $33,015.83
| Facility | | $13,564.58 | $22,070.30 | $33,015.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,638.47 / $19,355.91 / $32,931.85
| Facility | | $15,638.47 | $19,355.91 | $32,931.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,991.47 / $22,449.35 / $36,746.35
| Facility | | $13,991.47 | $22,449.35 | $36,746.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.54 / $12,593.64 / $18,750.81
| Facility | | $199.54 | $12,593.64 | $18,750.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,921.61 / $22,179.00 / $26,065.89
| Facility | | $15,921.61 | $22,179.00 | $26,065.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,369.25 / $23,657.15 / $29,821.76
| Facility | | $14,369.25 | $23,657.15 | $29,821.76 |