- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,663.60 / $15,663.60 / $18,564.40
| Facility | | $15,663.60 | $15,663.60 | $18,564.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,424.07 / $16,960.50 / $25,371.90
| Facility | | $10,424.07 | $16,960.50 | $25,371.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,810.88 / $15,856.17 / $26,977.44
| Facility | | $12,810.88 | $15,856.17 | $26,977.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,461.67 / $18,390.28 / $30,102.24
| Facility | | $11,461.67 | $18,390.28 | $30,102.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.34 / $9,677.92 / $15,334.30
| Facility | | $153.34 | $9,677.92 | $15,334.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,042.82 / $18,168.82 / $21,352.91
| Facility | | $13,042.82 | $18,168.82 | $21,352.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,771.14 / $19,379.70 / $24,429.69
| Facility | | $11,771.14 | $19,379.70 | $24,429.69 |