- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,413.90 / $15,413.90 / $18,268.59
| Facility | | $15,413.90 | $15,413.90 | $18,268.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,260.95 / $18,322.18 / $27,408.86
| Facility | | $11,260.95 | $18,322.18 | $27,408.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,606.71 / $15,603.47 / $26,547.50
| Facility | | $12,606.71 | $15,603.47 | $26,547.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,279.01 / $18,097.20 / $29,622.50
| Facility | | $11,279.01 | $18,097.20 | $29,622.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.65 / $10,454.91 / $15,115.68
| Facility | | $165.65 | $10,454.91 | $15,115.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,834.96 / $17,879.25 / $21,012.61
| Facility | | $12,834.96 | $17,879.25 | $21,012.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,583.55 / $19,070.84 / $24,040.35
| Facility | | $11,583.55 | $19,070.84 | $24,040.35 |