- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $17,378.01 / $18,197.01
| Facility | | $14,791.08 | $17,378.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $26,915.35
| Facility | | $10,715.19 | $18,620.87 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $27,542.29
| Facility | | $11,220.18 | $15,488.17 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $14,791.08 / $18,620.87
| Facility | | $12,882.50 | $14,791.08 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $17,378.01 / $28,183.83
| Facility | | $10,715.19 | $17,378.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.03 / $10,964.78 / $14,454.40
| Facility | | $123.03 | $10,964.78 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,952.62 / $20,892.96
| Facility | | $16,218.10 | $19,952.62 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $25,118.86
| Facility | | $10,715.19 | $18,620.87 | $25,118.86 |