- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,432.00 / $17,432.00 / $20,660.40
| Facility | | $17,432.00 | $17,432.00 | $20,660.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,035.33 / $22,836.24 / $34,161.62
| Facility | | $14,035.33 | $22,836.24 | $34,161.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,257.27 / $17,646.39 / $30,023.28
| Facility | | $14,257.27 | $17,646.39 | $30,023.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,755.73 / $20,466.59 / $33,500.87
| Facility | | $12,755.73 | $20,466.59 | $33,500.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $206.47 / $13,030.70 / $18,617.73
| Facility | | $206.47 | $13,030.70 | $18,617.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,515.40 / $20,220.13 / $23,763.73
| Facility | | $14,515.40 | $20,220.13 | $23,763.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,100.14 / $21,567.73 / $27,187.88
| Facility | | $13,100.14 | $21,567.73 | $27,187.88 |