- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,756.80 / $15,756.80 / $18,674.90
| Facility | | $15,756.80 | $15,756.80 | $18,674.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,471.27 / $18,664.37 / $27,920.76
| Facility | | $11,471.27 | $18,664.37 | $27,920.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,887.13 / $15,950.55 / $27,138.02
| Facility | | $12,887.13 | $15,950.55 | $27,138.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,529.90 / $18,499.75 / $30,281.42
| Facility | | $11,529.90 | $18,499.75 | $30,281.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $168.75 / $10,650.17 / $15,451.91
| Facility | | $168.75 | $10,650.17 | $15,451.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,120.46 / $18,276.96 / $21,480.02
| Facility | | $13,120.46 | $18,276.96 | $21,480.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,841.21 / $19,495.05 / $24,575.10
| Facility | | $11,841.21 | $19,495.05 | $24,575.10 |