- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,233.50 / $16,233.50 / $19,239.90
| Facility | | $16,233.50 | $16,233.50 | $19,239.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,925.67 / $19,403.71 / $29,026.77
| Facility | | $11,925.67 | $19,403.71 | $29,026.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,277.02 / $16,433.12 / $27,959.05
| Facility | | $13,277.02 | $16,433.12 | $27,959.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,878.72 / $19,059.43 / $31,197.55
| Facility | | $11,878.72 | $19,059.43 | $31,197.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.43 / $11,072.04 / $15,919.39
| Facility | | $175.43 | $11,072.04 | $15,919.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,517.40 / $18,829.91 / $22,129.87
| Facility | | $13,517.40 | $18,829.91 | $22,129.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,199.45 / $20,457.59 / $26,931.37
| Facility | | $12,199.45 | $20,457.59 | $26,931.37 |