- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,681.60 / $14,681.60 / $17,400.59
| Facility | | $14,681.60 | $14,681.60 | $17,400.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,815.27 / $17,597.02 / $26,324.07
| Facility | | $10,815.27 | $17,597.02 | $26,324.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,007.74 / $14,862.12 / $25,286.17
| Facility | | $12,007.74 | $14,862.12 | $25,286.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,743.12 / $17,237.36 / $28,215.07
| Facility | | $10,743.12 | $17,237.36 | $28,215.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $159.10 / $10,041.12 / $14,397.50
| Facility | | $159.10 | $10,041.12 | $14,397.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,225.14 / $17,029.78 / $20,014.25
| Facility | | $12,225.14 | $17,029.78 | $20,014.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,033.19 / $18,164.74 / $22,898.14
| Facility | | $11,033.19 | $18,164.74 | $22,898.14 |