- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,150.80 / $15,150.80 / $17,956.70
| Facility | | $15,150.80 | $15,150.80 | $17,956.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,740.08 / $17,474.68 / $26,141.06
| Facility | | $10,740.08 | $17,474.68 | $26,141.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,391.47 / $15,337.07 / $26,094.25
| Facility | | $12,391.47 | $15,337.07 | $26,094.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,086.44 / $17,788.22 / $29,116.75
| Facility | | $11,086.44 | $17,788.22 | $29,116.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.99 / $9,971.32 / $14,857.60
| Facility | | $157.99 | $9,971.32 | $14,857.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,615.82 / $17,574.00 / $20,653.86
| Facility | | $12,615.82 | $17,574.00 | $20,653.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,385.78 / $18,745.24 / $23,629.91
| Facility | | $11,385.78 | $18,745.24 | $23,629.91 |