- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,934.30 / $16,934.30 / $20,070.50
| Facility | | $16,934.30 | $16,934.30 | $20,070.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,408.41 / $20,189.15 / $30,201.74
| Facility | | $12,408.41 | $20,189.15 | $30,201.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,850.16 / $17,142.50 / $29,165.99
| Facility | | $13,850.16 | $17,142.50 | $29,165.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,391.50 / $19,882.20 / $32,544.29
| Facility | | $12,391.50 | $19,882.20 | $32,544.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $182.53 / $11,520.23 / $16,606.59
| Facility | | $182.53 | $11,520.23 | $16,606.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,100.92 / $19,642.75 / $23,085.17
| Facility | | $14,100.92 | $19,642.75 | $23,085.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,726.08 / $20,951.88 / $26,411.55
| Facility | | $12,726.08 | $20,951.88 | $26,411.55 |