- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,099.40 / $16,883.40 / $34,311.60
| Facility | | $13,099.40 | $16,883.40 | $34,311.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,964.34 / $18,155.72 / $20,538.41
| Facility | | $11,964.34 | $18,155.72 | $20,538.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,711.13 / $15,933.67 / $18,216.30
| Facility | | $12,711.13 | $15,933.67 | $18,216.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,456.16 / $18,508.50 / $24,071.10
| Facility | | $10,456.16 | $18,508.50 | $24,071.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,758.99 / $20,879.08 / $23,845.51
| Facility | | $13,758.99 | $20,879.08 | $23,845.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $18,466.46 / $26,032.55
| Facility | | $1,518.00 | $18,466.46 | $26,032.55 |