- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,358.30 / $16,358.30 / $19,387.90
| Facility | | $16,358.30 | $16,358.30 | $19,387.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,096.75 / $19,682.07 / $29,443.18
| Facility | | $12,096.75 | $19,682.07 | $29,443.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,379.10 / $16,559.47 / $28,174.02
| Facility | | $13,379.10 | $16,559.47 | $28,174.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,970.05 / $19,205.98 / $31,437.42
| Facility | | $11,970.05 | $19,205.98 | $31,437.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.95 / $11,230.88 / $16,046.23
| Facility | | $177.95 | $11,230.88 | $16,046.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,621.33 / $18,974.68 / $22,300.02
| Facility | | $13,621.33 | $18,974.68 | $22,300.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,293.25 / $20,239.28 / $25,513.26
| Facility | | $12,293.25 | $20,239.28 | $25,513.26 |