- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,516.20 / $14,516.20 / $17,204.50
| Facility | | $14,516.20 | $14,516.20 | $17,204.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,528.68 / $17,130.72 / $25,626.52
| Facility | | $10,528.68 | $17,130.72 | $25,626.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,872.45 / $14,694.67 / $25,001.27
| Facility | | $11,872.45 | $14,694.67 | $25,001.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,622.07 / $17,043.14 / $27,897.17
| Facility | | $10,622.07 | $17,043.14 | $27,897.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $9,775.04 / $14,235.28
| Facility | | $154.88 | $9,775.04 | $14,235.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,087.40 / $16,837.90 / $19,788.75
| Facility | | $12,087.40 | $16,837.90 | $19,788.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,908.87 / $17,960.08 / $22,640.15
| Facility | | $10,908.87 | $17,960.08 | $22,640.15 |