- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,105.70 / $16,105.70 / $19,088.40
| Facility | | $16,105.70 | $16,105.70 | $19,088.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,098.93 / $19,685.61 / $29,448.48
| Facility | | $12,098.93 | $19,685.61 | $29,448.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,172.48 / $16,303.73 / $27,738.90
| Facility | | $13,172.48 | $16,303.73 | $27,738.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,785.19 / $18,909.36 / $30,951.90
| Facility | | $11,785.19 | $18,909.36 | $30,951.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.98 / $11,232.91 / $16,049.12
| Facility | | $177.98 | $11,232.91 | $16,049.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,410.97 / $18,681.65 / $21,955.62
| Facility | | $13,410.97 | $18,681.65 | $21,955.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,103.39 / $19,926.70 / $25,119.23
| Facility | | $12,103.39 | $19,926.70 | $25,119.23 |