- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,577.90 / $18,577.90 / $22,018.50
| Facility | | $18,577.90 | $18,577.90 | $22,018.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,483.94 / $21,939.10 / $32,819.56
| Facility | | $13,483.94 | $21,939.10 | $32,819.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,194.47 / $18,806.37 / $31,996.86
| Facility | | $15,194.47 | $18,806.37 | $31,996.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,594.23 / $21,811.98 / $35,703.06
| Facility | | $13,594.23 | $21,811.98 | $35,703.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.36 / $12,518.78 / $18,218.43
| Facility | | $198.36 | $12,518.78 | $18,218.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,469.57 / $21,549.30 / $25,325.84
| Facility | | $15,469.57 | $21,549.30 | $25,325.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,961.28 / $22,985.48 / $28,975.07
| Facility | | $13,961.28 | $22,985.48 | $28,975.07 |