- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,083.20 / $18,083.20 / $21,432.20
| Facility | | $18,083.20 | $18,083.20 | $21,432.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,542.44 / $20,407.23 / $30,527.97
| Facility | | $12,542.44 | $20,407.23 | $30,527.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,789.82 / $18,305.54 / $31,144.75
| Facility | | $14,789.82 | $18,305.54 | $31,144.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,232.20 / $21,231.10 / $34,752.25
| Facility | | $13,232.20 | $21,231.10 | $34,752.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.51 / $11,644.67 / $17,733.27
| Facility | | $184.51 | $11,644.67 | $17,733.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,057.60 / $20,975.42 / $24,651.38
| Facility | | $15,057.60 | $20,975.42 | $24,651.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,589.48 / $22,373.35 / $28,203.44
| Facility | | $13,589.48 | $22,373.35 | $28,203.44 |