- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,531.30 / $16,531.30 / $19,592.80
| Facility | | $16,531.30 | $16,531.30 | $19,592.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,068.42 / $19,635.97 / $29,374.22
| Facility | | $12,068.42 | $19,635.97 | $29,374.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,520.54 / $16,734.53 / $28,471.87
| Facility | | $13,520.54 | $16,734.53 | $28,471.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,096.60 / $19,409.02 / $31,769.77
| Facility | | $12,096.60 | $19,409.02 | $31,769.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.53 / $11,204.58 / $16,211.38
| Facility | | $177.53 | $11,204.58 | $16,211.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,765.34 / $19,175.29 / $22,535.77
| Facility | | $13,765.34 | $19,175.29 | $22,535.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,423.21 / $20,453.25 / $25,782.98
| Facility | | $12,423.21 | $20,453.25 | $25,782.98 |