- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,431.90 / $13,431.90 / $15,919.50
| Facility | | $13,431.90 | $13,431.90 | $15,919.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,412.82 / $15,315.17 / $22,910.56
| Facility | | $9,412.82 | $15,315.17 | $22,910.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,985.67 / $13,597.09 / $23,133.88
| Facility | | $10,985.67 | $13,597.09 | $23,133.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,828.69 / $15,770.16 / $25,813.48
| Facility | | $9,828.69 | $15,770.16 | $25,813.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.47 / $8,739.06 / $13,172.02
| Facility | | $138.47 | $8,739.06 | $13,172.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,184.57 / $15,580.25 / $18,310.70
| Facility | | $11,184.57 | $15,580.25 | $18,310.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,094.07 / $16,618.61 / $20,949.11
| Facility | | $10,094.07 | $16,618.61 | $20,949.11 |