- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,036.59 / $19,036.59 / $22,562.10
| Facility | | $19,036.59 | $19,036.59 | $22,562.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,495.93 / $21,958.60 / $32,848.73
| Facility | | $13,495.93 | $21,958.60 | $32,848.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,569.60 / $19,270.66 / $32,786.81
| Facility | | $15,569.60 | $19,270.66 | $32,786.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,929.85 / $22,350.48 / $36,584.51
| Facility | | $13,929.85 | $22,350.48 | $36,584.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.53 / $12,529.90 / $18,668.23
| Facility | | $198.53 | $12,529.90 | $18,668.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,851.49 / $22,081.32 / $25,951.09
| Facility | | $15,851.49 | $22,081.32 | $25,951.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,305.96 / $23,552.96 / $29,690.42
| Facility | | $14,305.96 | $23,552.96 | $29,690.42 |