- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,722.20 / $14,722.20 / $17,448.70
| Facility | | $14,722.20 | $14,722.20 | $17,448.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,107.31 / $18,072.18 / $27,034.89
| Facility | | $11,107.31 | $18,072.18 | $27,034.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,040.95 / $14,903.22 / $25,356.10
| Facility | | $12,040.95 | $14,903.22 | $25,356.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,772.83 / $17,285.03 / $28,293.10
| Facility | | $10,772.83 | $17,285.03 | $28,293.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.38 / $10,312.26 / $14,733.74
| Facility | | $163.38 | $10,312.26 | $14,733.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,258.95 / $17,076.87 / $20,069.61
| Facility | | $12,258.95 | $17,076.87 | $20,069.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,063.70 / $18,214.98 / $22,961.47
| Facility | | $11,063.70 | $18,214.98 | $22,961.47 |