- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,486.10 / $14,486.10 / $17,168.90
| Facility | | $14,486.10 | $14,486.10 | $17,168.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,486.18 / $17,061.57 / $25,523.08
| Facility | | $10,486.18 | $17,061.57 | $25,523.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,847.85 / $14,664.22 / $24,949.47
| Facility | | $11,847.85 | $14,664.22 | $24,949.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,600.07 / $17,007.83 / $27,839.37
| Facility | | $10,600.07 | $17,007.83 | $27,839.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.26 / $9,735.59 / $14,205.79
| Facility | | $154.26 | $9,735.59 | $14,205.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,062.36 / $16,803.02 / $19,747.75
| Facility | | $12,062.36 | $16,803.02 | $19,747.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,886.27 / $17,922.87 / $22,593.24
| Facility | | $10,886.27 | $17,922.87 | $22,593.24 |