- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,105.80 / $18,105.80 / $21,458.90
| Facility | | $18,105.80 | $18,105.80 | $21,458.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,140.69 / $21,380.60 / $31,984.08
| Facility | | $13,140.69 | $21,380.60 | $31,984.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,808.27 / $18,328.37 / $31,183.60
| Facility | | $14,808.27 | $18,328.37 | $31,183.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,248.71 / $21,257.58 / $34,795.60
| Facility | | $13,248.71 | $21,257.58 | $34,795.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.31 / $12,200.09 / $17,755.39
| Facility | | $193.31 | $12,200.09 | $17,755.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,076.38 / $21,001.59 / $24,682.13
| Facility | | $15,076.38 | $21,001.59 | $24,682.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,606.43 / $22,401.26 / $28,238.62
| Facility | | $13,606.43 | $22,401.26 | $28,238.62 |