- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,821.40 / $13,821.40 / $16,381.10
| Facility | | $13,821.40 | $13,821.40 | $16,381.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,044.85 / $16,343.51 / $24,448.90
| Facility | | $10,044.85 | $16,343.51 | $24,448.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,304.22 / $13,991.37 / $23,804.69
| Facility | | $11,304.22 | $13,991.37 | $23,804.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,113.69 / $16,227.45 / $26,561.99
| Facility | | $10,113.69 | $16,227.45 | $26,561.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $147.76 / $9,325.85 / $13,553.97
| Facility | | $147.76 | $9,325.85 | $13,553.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,508.89 / $16,032.03 / $18,841.65
| Facility | | $11,508.89 | $16,032.03 | $18,841.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,386.77 / $17,100.50 / $21,556.57
| Facility | | $10,386.77 | $17,100.50 | $21,556.57 |