- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $16,218.10 / $20,892.96
| Facility | | $13,803.84 | $16,218.10 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $22,387.21
| Facility | | $22,387.21 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $16,595.87 / $28,840.32
| Facility | | $7,079.46 | $16,595.87 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $19,498.45 / $26,915.35
| Facility | | $14,791.08 | $19,498.45 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $18,620.87 / $29,512.09
| Facility | | $8,912.51 | $18,620.87 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $16,595.87 / $25,703.96
| Facility | | $10,471.29 | $16,595.87 | $25,703.96 |