- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,072.70 / $19,072.70 / $22,604.90
| Facility | | $19,072.70 | $19,072.70 | $22,604.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,997.19 / $22,774.18 / $34,068.79
| Facility | | $13,997.19 | $22,774.18 | $34,068.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,599.11 / $19,307.20 / $32,848.97
| Facility | | $15,599.11 | $19,307.20 | $32,848.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,956.26 / $22,392.85 / $36,653.87
| Facility | | $13,956.26 | $22,392.85 | $36,653.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.91 / $12,995.29 / $18,703.62
| Facility | | $205.91 | $12,995.29 | $18,703.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,881.54 / $22,123.19 / $26,000.29
| Facility | | $15,881.54 | $22,123.19 | $26,000.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,333.08 / $23,597.61 / $29,746.71
| Facility | | $14,333.08 | $23,597.61 | $29,746.71 |