- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,454.40 / $17,378.01
| Facility | | $12,022.64 | $14,454.40 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $20,892.96
| Facility | | $12,882.50 | $12,882.50 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $14,791.08 / $22,908.68
| Facility | | $11,481.54 | $14,791.08 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $18,197.01 / $18,197.01
| Facility | | $8,912.51 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $16,595.87 / $24,547.09
| Facility | | $12,022.64 | $16,595.87 | $24,547.09 |