- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,190.00 / $18,190.00 / $21,558.70
| Facility | | $18,190.00 | $18,190.00 | $21,558.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,389.14 / $21,784.85 / $32,588.81
| Facility | | $13,389.14 | $21,784.85 | $32,588.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,877.15 / $18,413.62 / $31,328.64
| Facility | | $14,877.15 | $18,413.62 | $31,328.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,310.33 / $21,356.46 / $34,957.44
| Facility | | $13,310.33 | $21,356.46 | $34,957.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.96 / $12,430.76 / $17,837.97
| Facility | | $196.96 | $12,430.76 | $17,837.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,146.50 / $21,099.27 / $24,796.93
| Facility | | $15,146.50 | $21,099.27 | $24,796.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,669.71 / $22,505.45 / $28,369.96
| Facility | | $13,669.71 | $22,505.45 | $28,369.96 |