- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,826.09 / $18,826.09 / $22,312.60
| Facility | | $18,826.09 | $18,826.09 | $22,312.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,930.78 / $17,784.96 / $26,605.22
| Facility | | $10,930.78 | $17,784.96 | $26,605.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,397.41 / $19,057.55 / $32,424.21
| Facility | | $15,397.41 | $19,057.55 | $32,424.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,775.79 / $22,103.30 / $36,179.91
| Facility | | $13,775.79 | $22,103.30 | $36,179.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.80 / $10,148.36 / $16,114.46
| Facility | | $160.80 | $10,148.36 | $16,114.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,676.18 / $21,837.12 / $25,664.09
| Facility | | $15,676.18 | $21,837.12 | $25,664.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,147.75 / $23,292.48 / $29,362.06
| Facility | | $14,147.75 | $23,292.48 | $29,362.06 |