- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,248.50 / $15,248.50 / $18,072.50
| Facility | | $15,248.50 | $15,248.50 | $18,072.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,072.44 / $18,015.45 / $26,950.02
| Facility | | $11,072.44 | $18,015.45 | $26,950.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,471.42 / $15,436.02 / $26,262.60
| Facility | | $12,471.42 | $15,436.02 | $26,262.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,157.96 / $17,902.98 / $29,304.60
| Facility | | $11,157.96 | $17,902.98 | $29,304.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.88 / $10,279.87 / $14,953.46
| Facility | | $162.88 | $10,279.87 | $14,953.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,697.22 / $17,687.38 / $20,787.11
| Facility | | $12,697.22 | $17,687.38 | $20,787.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,459.23 / $18,866.18 / $23,782.36
| Facility | | $11,459.23 | $18,866.18 | $23,782.36 |