- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,838.09 / $17,838.09 / $21,141.60
| Facility | | $17,838.09 | $17,838.09 | $21,141.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,570.03 / $22,079.16 / $33,029.08
| Facility | | $13,570.03 | $22,079.16 | $33,029.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,589.35 / $18,057.40 / $30,722.58
| Facility | | $14,589.35 | $18,057.40 | $30,722.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,052.84 / $20,943.31 / $34,281.18
| Facility | | $13,052.84 | $20,943.31 | $34,281.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.62 / $12,598.70 / $18,000.50
| Facility | | $199.62 | $12,598.70 | $18,000.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,853.49 / $20,691.09 / $24,317.23
| Facility | | $14,853.49 | $20,691.09 | $24,317.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,405.27 / $22,070.08 / $27,821.13
| Facility | | $13,405.27 | $22,070.08 | $27,821.13 |