- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,498.45 / $32,359.37
| Facility | | $12,882.50 | $19,498.45 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $14,125.38
| Facility | | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $25,703.96
| Facility | | $11,220.18 | $15,488.17 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $13,182.57 / $16,595.87
| Facility | | $10,471.29 | $13,182.57 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,595.87 / $24,547.09
| Facility | | $10,471.29 | $16,595.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $15,848.93 / $21,379.62
| Facility | | $11,748.98 | $15,848.93 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $17,378.01 / $23,988.33
| Facility | | $6,025.60 | $17,378.01 | $23,988.33 |