- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,170.40 / $18,170.40 / $21,535.50
| Facility | | $18,170.40 | $18,170.40 | $21,535.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,630.31 / $23,804.29 / $35,609.76
| Facility | | $14,630.31 | $23,804.29 | $35,609.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,861.16 / $18,393.83 / $31,294.97
| Facility | | $14,861.16 | $18,393.83 | $31,294.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,296.02 / $21,333.50 / $34,919.87
| Facility | | $13,296.02 | $21,333.50 | $34,919.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.22 / $13,583.08 / $19,406.96
| Facility | | $215.22 | $13,583.08 | $19,406.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,130.22 / $21,076.59 / $24,770.28
| Facility | | $15,130.22 | $21,076.59 | $24,770.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,683.53 / $22,314.88 / $28,339.47
| Facility | | $12,683.53 | $22,314.88 | $28,339.47 |