- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,338.80 / $18,338.80 / $21,735.10
| Facility | | $18,338.80 | $18,338.80 | $21,735.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,846.81 / $22,529.51 / $33,702.76
| Facility | | $13,846.81 | $22,529.51 | $33,702.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,998.91 / $18,564.33 / $31,585.05
| Facility | | $14,998.91 | $18,564.33 | $31,585.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,419.27 / $21,531.25 / $35,243.55
| Facility | | $13,419.27 | $21,531.25 | $35,243.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $203.69 / $12,855.67 / $18,367.66
| Facility | | $203.69 | $12,855.67 | $18,367.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,270.47 / $21,271.96 / $24,999.88
| Facility | | $15,270.47 | $21,271.96 | $24,999.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,781.59 / $22,689.65 / $28,602.15
| Facility | | $13,781.59 | $22,689.65 | $28,602.15 |