- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,561.40 / $17,561.40 / $20,813.70
| Facility | | $17,561.40 | $17,561.40 | $20,813.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,015.03 / $19,549.09 / $29,244.25
| Facility | | $12,015.03 | $19,549.09 | $29,244.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,363.04 / $17,777.30 / $30,246.02
| Facility | | $14,363.04 | $17,777.30 | $30,246.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,850.37 / $20,618.43 / $33,749.42
| Facility | | $12,850.37 | $20,618.43 | $33,749.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.75 / $11,155.00 / $17,221.55
| Facility | | $176.75 | $11,155.00 | $17,221.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,623.09 / $20,370.15 / $23,940.03
| Facility | | $14,623.09 | $20,370.15 | $23,940.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,197.33 / $21,727.74 / $27,389.58
| Facility | | $13,197.33 | $21,727.74 | $27,389.58 |