- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,001.90 / $16,001.90 / $18,965.50
| Facility | | $16,001.90 | $16,001.90 | $18,965.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,639.08 / $18,937.41 / $28,329.21
| Facility | | $11,639.08 | $18,937.41 | $28,329.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,087.61 / $16,198.69 / $27,560.19
| Facility | | $13,087.61 | $16,198.69 | $27,560.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,709.26 / $18,787.54 / $30,752.49
| Facility | | $11,709.26 | $18,787.54 | $30,752.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.22 / $10,805.97 / $15,692.28
| Facility | | $171.22 | $10,805.97 | $15,692.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,324.56 / $18,561.29 / $21,814.17
| Facility | | $13,324.56 | $18,561.29 | $21,814.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,025.42 / $19,798.33 / $24,957.40
| Facility | | $12,025.42 | $19,798.33 | $24,957.40 |