- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,200.50 / $17,200.50 / $20,385.90
| Facility | | $17,200.50 | $17,200.50 | $20,385.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,289.63 / $19,995.89 / $29,912.63
| Facility | | $12,289.63 | $19,995.89 | $29,912.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,067.86 / $17,411.95 / $29,624.42
| Facility | | $14,067.86 | $17,411.95 | $29,624.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,586.27 / $20,194.70 / $33,055.82
| Facility | | $12,586.27 | $20,194.70 | $33,055.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.79 / $11,409.95 / $16,867.62
| Facility | | $180.79 | $11,409.95 | $16,867.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,322.56 / $19,951.50 / $23,448.03
| Facility | | $14,322.56 | $19,951.50 | $23,448.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,926.11 / $21,281.20 / $26,826.69
| Facility | | $12,926.11 | $21,281.20 | $26,826.69 |