- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,203.10 / $19,280.40 / $25,341.10
| Facility | | $13,203.10 | $19,280.40 | $25,341.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,051.44 / $25,246.42 / $25,511.93
| Facility | | $16,051.44 | $25,246.42 | $25,511.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,164.24 / $14,064.17 / $23,787.66
| Facility | | $5,164.24 | $14,064.17 | $23,787.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,412.49 / $19,366.06 / $32,414.41
| Facility | | $13,412.49 | $19,366.06 | $32,414.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,607.64 / $21,612.78 / $31,556.42
| Facility | | $16,607.64 | $21,612.78 | $31,556.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,012.26 / $18,900.77 / $29,462.02
| Facility | | $11,012.26 | $18,900.77 | $29,462.02 |