- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,839.59 / $17,839.59 / $21,143.40
| Facility | | $17,839.59 | $17,839.59 | $21,143.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,323.76 / $21,678.47 / $32,429.67
| Facility | | $13,323.76 | $21,678.47 | $32,429.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,590.58 / $18,058.93 / $30,725.17
| Facility | | $14,590.58 | $18,058.93 | $30,725.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,053.94 / $20,945.08 / $34,284.07
| Facility | | $13,053.94 | $20,945.08 | $34,284.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.00 / $12,370.06 / $17,673.84
| Facility | | $196.00 | $12,370.06 | $17,673.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,854.74 / $20,692.84 / $24,319.28
| Facility | | $14,854.74 | $20,692.84 | $24,319.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,406.40 / $22,071.94 / $27,823.48
| Facility | | $13,406.40 | $22,071.94 | $27,823.48 |