- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,848.93 / $18,197.01
| Facility | | $12,302.69 | $15,848.93 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $17,782.79 / $17,782.79
| Facility | | $17,782.79 | $17,782.79 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,125.38 / $16,982.44
| Facility | | $12,022.64 | $14,125.38 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $18,197.01 / $22,387.21
| Facility | | $11,220.18 | $18,197.01 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $16,595.87 / $21,379.62
| Facility | | $1,513.56 | $16,595.87 | $21,379.62 |