- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $20,417.38 / $21,379.62
| Facility | | $17,378.01 | $20,417.38 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $21,877.62 / $31,622.78
| Facility | | $12,589.25 | $21,877.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $18,197.01 / $32,359.37
| Facility | | $13,182.57 | $18,197.01 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $16,982.44 / $21,877.62
| Facility | | $15,135.61 | $16,982.44 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,952.62 / $33,113.11
| Facility | | $12,589.25 | $19,952.62 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $12,882.50 / $16,982.44
| Facility | | $144.54 | $12,882.50 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $23,442.29 / $24,547.09
| Facility | | $18,620.87 | $23,442.29 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $21,877.62 / $29,512.09
| Facility | | $12,589.25 | $21,877.62 | $29,512.09 |