- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $16,982.44 / $17,782.79
| Facility | | $14,125.38 | $16,982.44 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $18,197.01 / $26,302.68
| Facility | | $10,471.29 | $18,197.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $14,791.08 / $26,915.35
| Facility | | $10,964.78 | $14,791.08 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $14,125.38 / $18,197.01
| Facility | | $12,302.69 | $14,125.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,595.87 / $27,542.29
| Facility | | $10,471.29 | $16,595.87 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.23 / $10,715.19 / $14,125.38
| Facility | | $120.23 | $10,715.19 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $19,498.45 / $20,417.38
| Facility | | $15,488.17 | $19,498.45 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,782.79 / $24,547.09
| Facility | | $10,471.29 | $17,782.79 | $24,547.09 |