- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,725.10 / $21,733.30 / $29,866.50
| Facility | | $13,725.10 | $21,733.30 | $29,866.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,476.13 / $14,476.13 / $14,476.13
| Facility | | $14,476.13 | $14,476.13 | $14,476.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,251.14 / $19,630.71 / $29,740.95
| Facility | | $12,251.14 | $19,630.71 | $29,740.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,891.95 / $19,957.23 / $30,913.81
| Facility | | $12,891.95 | $19,957.23 | $30,913.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,733.31 / $19,179.73 / $29,255.16
| Facility | | $11,733.31 | $19,179.73 | $29,255.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,282.67 / $23,074.52 / $33,197.51
| Facility | | $7,282.67 | $23,074.52 | $33,197.51 |