- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,383.40 / $15,260.60 / $21,724.70
| Facility | | $11,383.40 | $15,260.60 | $21,724.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,559.24 / $15,653.84 / $17,501.99
| Facility | | $11,559.24 | $15,653.84 | $17,501.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,010.54 / $14,286.89 / $20,708.56
| Facility | | $9,010.54 | $14,286.89 | $20,708.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.56 / $13,709.74 / $24,814.00
| Facility | | $9,930.56 | $13,709.74 | $24,814.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.56 / $145.40 / $231.73
| Facility | | $105.56 | $145.40 | $231.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,378.45 / $15,117.93 / $23,997.62
| Facility | | $10,378.45 | $15,117.93 | $23,997.62 |