- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,920.70 / $15,920.70 / $18,869.20
| Facility | | $15,920.70 | $15,920.70 | $18,869.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,996.50 / $19,518.95 / $29,199.17
| Facility | | $11,996.50 | $19,518.95 | $29,199.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,021.19 / $16,116.48 / $27,420.33
| Facility | | $13,021.19 | $16,116.48 | $27,420.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,649.84 / $18,692.20 / $30,596.43
| Facility | | $11,649.84 | $18,692.20 | $30,596.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.47 / $11,137.81 / $15,913.25
| Facility | | $176.47 | $11,137.81 | $15,913.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,256.95 / $18,467.09 / $21,703.47
| Facility | | $13,256.95 | $18,467.09 | $21,703.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,964.39 / $19,697.84 / $24,830.75
| Facility | | $11,964.39 | $19,697.84 | $24,830.75 |