- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,883.10 / $15,883.10 / $18,824.70
| Facility | | $15,883.10 | $15,883.10 | $18,824.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,657.61 / $18,967.55 / $28,374.30
| Facility | | $11,657.61 | $18,967.55 | $28,374.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,990.45 / $16,078.43 / $27,355.58
| Facility | | $12,990.45 | $16,078.43 | $27,355.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,622.33 / $18,648.06 / $30,524.18
| Facility | | $11,622.33 | $18,648.06 | $30,524.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $171.49 / $10,823.17 / $15,575.78
| Facility | | $171.49 | $10,823.17 | $15,575.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,225.64 / $18,423.49 / $21,652.22
| Facility | | $13,225.64 | $18,423.49 | $21,652.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,936.14 / $19,651.34 / $24,772.11
| Facility | | $11,936.14 | $19,651.34 | $24,772.11 |