- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,278.60 / $16,278.60 / $19,293.40
| Facility | | $16,278.60 | $16,278.60 | $19,293.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,780.74 / $19,167.90 / $28,674.01
| Facility | | $11,780.74 | $19,167.90 | $28,674.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,313.92 / $16,478.79 / $28,036.75
| Facility | | $13,313.92 | $16,478.79 | $28,036.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,911.73 / $19,112.40 / $31,284.25
| Facility | | $11,911.73 | $19,112.40 | $31,284.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.30 / $10,937.49 / $15,963.63
| Facility | | $173.30 | $10,937.49 | $15,963.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,554.97 / $18,882.24 / $22,191.37
| Facility | | $13,554.97 | $18,882.24 | $22,191.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,233.35 / $20,140.66 / $25,388.96
| Facility | | $12,233.35 | $20,140.66 | $25,388.96 |