- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,741.09 / $21,481.60 / $35,664.50
| Facility | | $16,741.09 | $21,481.60 | $35,664.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,124.92 / $13,124.92 / $19,612.81
| Facility | | $13,124.92 | $13,124.92 | $19,612.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,609.70 / $19,263.61 / $32,558.35
| Facility | | $12,609.70 | $19,263.61 | $32,558.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,516.45 / $22,912.59 / $32,945.51
| Facility | | $18,516.45 | $22,912.59 | $32,945.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,070.46 / $23,002.83 / $56,269.23
| Facility | | $11,070.46 | $23,002.83 | $56,269.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,070.46 / $21,962.27 / $30,866.89
| Facility | | $11,070.46 | $21,962.27 | $30,866.89 |