- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,135.61 / $15,488.17
| Facility | | $12,589.25 | $15,135.61 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,218.10 / $23,442.29
| Facility | | $9,332.54 | $16,218.10 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $13,182.57 / $23,442.29
| Facility | | $9,772.37 | $13,182.57 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $12,589.25 / $16,218.10
| Facility | | $10,964.78 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $24,547.09
| Facility | | $9,332.54 | $14,791.08 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $9,549.93 / $12,589.25
| Facility | | $107.15 | $9,549.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $17,378.01 / $17,782.79
| Facility | | $13,803.84 | $17,378.01 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,848.93 / $21,877.62
| Facility | | $9,332.54 | $15,848.93 | $21,877.62 |