- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,747.80 / $17,747.80 / $21,034.70
| Facility | | $17,747.80 | $17,747.80 | $21,034.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,674.30 / $20,621.75 / $30,848.90
| Facility | | $12,674.30 | $20,621.75 | $30,848.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,515.55 / $17,966.07 / $30,567.18
| Facility | | $14,515.55 | $17,966.07 | $30,567.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,986.81 / $20,837.38 / $34,107.78
| Facility | | $12,986.81 | $20,837.38 | $34,107.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.44 / $11,767.08 / $17,404.41
| Facility | | $186.44 | $11,767.08 | $17,404.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,778.36 / $20,586.43 / $24,194.23
| Facility | | $14,778.36 | $20,586.43 | $24,194.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,337.46 / $21,958.45 / $27,680.41
| Facility | | $13,337.46 | $21,958.45 | $27,680.41 |